Prior 2012-2015 Medicaid Managed Care Contract & Report Guide Versions

REPORT GUIDE HISTORY:

October 1, 2013 Report Guide Version - Replaced by the January 1, 2014 Draft Version

The October 1, 2013 Report Guide for the Medicaid Reform and non-Reform HMOs, Capitated PSNs and FFS PSNs is located below. The October 1, 2013 Report Guide will be posted here when the Draft January 1, 2014 version becomes effective.

Report Guide Revisions Summary [280KB, PDF] Effective October 1, 2013
Report Guide Transmittal [41KB, PDF] EffectiveJuly 1, 2013

July 1, 2013 Report Guide Version - Replaced by the October 1, 2013 Draft Version

The July 1, 2013 Report Guide for the Medicaid Reform and non-Reform HMOs, Capitated PSNs and FFS PSNs is located below. The July 1, 2013 Report Guide will be posted here when the Draft October 1, 2013 version becomes effective.

Report Guide [2.87MB, PDF] Effective July 1, 2013
Report Guide Revisions Table [293KB, PDF] Effective July 1, 2013
Report Guide Transmittal [43KB, PDF] Effective 4-1-2013

April 1, 2013 Report Guide Version - Replaced by the July 1, 2013 Draft Version

The April 1, 2013 Report Guide for the Medicaid Reform and non-Reform HMOs, Capitated PSNs and FFS PSNs is located below. The April 1, 2013 Report Guide will be posted here when the Draft July 1, 2013 version becomes effective.

Report Guide [2.56 MB, PDF] Effective April 1, 2013
Report Guide Revisions Table [277 KB, PDF] Effective April 1, 2013
Report Guide Transmittal [48 KB, PDF] Effective 01-01-2013

January 1, 2013 Report Guide Version - Replaced by the April 1, 2013 Draft Version

The January 1, 2013 Report Guide for the Medicaid Reform and non-Reform HMOs, Capitated PSNs and FFS PSNs is located below. The January 1, 2013 Report Guide will be posted here when the Draft April 1, 2013 version becomes effective.

Report Guide [2.82 MB, PDF] Effective 1-01-2013
Report Guide Revisions Table [311 KB, PDF] Effective 1-01-2013
Report Guide Transmittal [43 KB, PDF] Effective 10-01-2012

October 1, 2012 Report Guide Version - Replaced by the January 1, 2013 Draft Version

The October 1, 2012 Report Guide for the Medicaid Reform and non-Reform HMOs, Capitated PSNs and FFS PSNs is located below.

Report Guide [2.04 MB, PDF] Effective 10-01-2012
Report Guide Revisions Table [306 KB, PDF] Effective 10-01-2012
Report Guide Transmittal [37 KB, PDF] Effective 07-01-2012

Health Plan Contract History:

Final health plan contract posted March 21, 2013 were replaced by versions posted November 13, 2013 that were updated after the Rate/General Amendment that was completed in December/January.

Attachment I - FFS [521KB, PDF] Posted 3-21-2013, Effective 1-1-2013
Attachment I - Capitated [607KB, PDF] Posted 3-21-2013, Effective 1-1-2013
Attachment II and General Amendment I [2.13MB, PDF] Posted 3-21-2013, Effective 1-1-2013
Attachment II - Exhibits [715 KB, PDF] Posted 8-29-2012, Effective 9-01-2012

Final health plan contract posted August 29, 2012 were replaced by versions posted March 21, 2013 that were updated after the Rate/General Amendment that was completed in December/January. Only the Exhibits document did not change and remains effective as of September 1, 2012.

Attachment I - FFS [520 KB, PDF] Posted 8-29-2012, Effective 9-01-2012
Attachment I - Capitated [606 KB, PDF] Posted 8-29-2012, Effective 9-01-2012
Attachment II [2.14 MB, PDF] Posted 8-30-2012, Effective 9-01-2012

Final health plan contract posted August 10, 2012 were replaced by versions posted August 29, 2012 that includes edits by Procurement dealing with structure, grammatic errors, etc.

Attachment I - FFS [515 KB, PDF] Effective 9-01-2012
Attachment I - Capitated [615 KB, PDF] Effective 9-01-2012
Attachment II [2.75 MB, PDF] Effective 9-01-2012
Attachment II - Exhibits [704 KB, PDF] Effective 9-01-2012

DRAFT 2012-2015 Health Plan Contract:

This is a preliminary draft of the 2012-15 Medicaid Health Plan Contract (strike-through/ track changes version).  Please note that the changes from the last general amendment (telemedicine) are also included as track-changes.  Most sections of this draft are final but some are still undergoing revision (particularly Attachment II, Section XIV, Sanctions, and Section XII, Reporting Requirements).  Those sections are marked under review and the Agency will provide draft language once it is available.  This document was reviewed with the health plans by conference call on June 1, 2012. The Agency is reviewing written comments received and a final contract is expected by July 31, 2012.

DRAFT 2012-2015 Attachment I FFS [513 KB, PDF]
DRAFT 2012-2015 Attachment I Capitated [611 KB, PDF]
DRAFT 2012-2015 Attachment II [2.56 MB, PDF]
DRAFT 2012-2015 Exhibits [907 KB, PDF]