| Today, the Centers for Medicare & Medicaid Services (CMS) is announcing the availability of the Managed Care Program Annual Report in MDCT-Managed Care Reporting.In a CMCS Informational Bulletin (CIB) dated June 28, 2021, CMS released a reporting template for the Managed Care Program Annual Report, and announced the development of a web-based reporting portal for the collection of all required managed care reports. In another CIB dated July 6, 2022, CMS provided an update on the web-based reporting portal, and released two additional reporting templates, related to Medical Loss Ratio (MLR) and network adequacy and access assurances. In the July, 2022 CIB, CMS also committed to announcing the availability of each report when they are ready for states to submit them through the web-based reporting portal, known as MDCT-Managed Care Reporting. Managed Care Program Annual Report Available in MDCT As described in the CIBs, this report is required annually, and must be submitted through MDCT-Managed Care Reporting. The first report is due from each state based on the schedule below.
Access to MDCT-Managed Care Reporting is limited to state employees nominated by their state leadership. CMS has been in contact with each states representative to the Managed Care Technical Advisory Group (TAG) to explain the process to nominate and apply for access. Each State should follow the instructions provided to gain access to the system. Other Reporting Reminders CMS would also like to remind states of the submission requirements (originally published in the July, 2022 CIB) for the MLR Report and the Network Adequacy and Access Assurances Report. In the future, these reports will be collected through MDCT-Managed Care Reporting, and CMS will notify states when the web-based forms are available. However, in the interim, states should follow the guidelines below to submit the reports. Medicaid Loss Ratio (MLR) Report This report is required to be submitted annually at the same time the annual rate certification is submitted. The requirement for states to submit this information to CMS began for rating periods starting on or after July 1, 2017. However, prior to June 2022, there had been no requirement to use a standard reporting template. As of October 1, 2022, states submitting rate certification packages are required to use the template. Until CMS provides notice that the MLR Report can be submitted via MDCT-Managed Care Reporting, it should be submitted as additional documentation with the annual rate certification submission. Network Adequacy and Access Assurances Report The requirement for states to submit this information to CMS began with all contracts with rating periods beginning on or after July 1, 2018. However, prior to June 2022, there had been no requirement to use a standard reporting template. As of October 1, 2022, states are required to use the template. The information is required to be submitted: At the time the state enters into a contract with each MCO, PIHP, or PAHP; On an annual basis; and Any time there is a significant change in the operations that would affect the adequacy of capacity and services of an MCO, PIHP, or PAHP. Until CMS provides notice that the Network Adequacy and Access Assurances Report can be submitted via MDCT-Managed Care Reporting, CMS recommends that the report be submitted as supporting documentation with the associated managed care contract, including a new contract, a renewal, or an amendment. More information is available on Medicaid.gov about all required managed care reporting requirements. | 