Managed Care Enrollment Process Updates Medicaid State Plan Amendment 21-0018 Public Notice

Thu, 06/03/2021

Notice: Managed Care Enrollment Process Updates Medicaid State Plan Amendment 21-0018 Public Notice is now available online. 

Description: The Health Care Authority (HCA) intends to submit Medicaid State Plan Amendment (SPA) 21-0018 in order to limit default (automated) assignment of Medicaid beneficiaries to a Managed Care Organization (MCO) based on statewide market share. Once an MCO reaches a level of statewide Apple Health market share that could adversely affect the ability of the other MCOs to meet network adequacy requirements, HCA will no longer include that MCO in the pool of MCOs for default assignment. Medicaid beneficiaries will continue to be able to choose any MCO regardless of this limit.