CMS 2015 Managed Care Rate Setting Consultation Guide

In September 2014, the Centers for Medicare and Medicaid Services (CMS) published its 2015 Managed Care Rate Setting Consultation Guide for states to use when setting rates for rating periods starting in calendar year 2015 with any managed care program subject to the actuarial soundness requirements in 42 CFR §438.6. The guide is based on the experience from 2014 and describes information that CMS expects states to provide when developing the actuarial rate certifications. This information will be the focus of CMS’ review of capitation rates in 2015, and may also be helpful to states in their conversations with . . .