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New State Guidance on Claiming Methodologies for Medicaid Managed Care

Today, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter (SMDL) that provides guidance to support states in developing managed care claiming methodologies for claiming federal financial participation at a rate that is different than a states federal medical assistance percentage specified in section 1905(b) of the Social Security Act. A differential match rate can be claimed for expenditures related to certain Medicaid benefits or beneficiary populations, such as for family planning services or community-based mobile crisis intervention services authorized by Section 9813 of the American Rescue Plan Act of 2021. This SMDL outlines steps that states may take to properly identify the portion of Medicaid capitation rates attributable to the particular benefit or population subject to a differential match rate.

For more on the guidance, you can read the full letter on Medicaid.gov.

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