- Reports & Announcements
- 2016 MO HealthNet Managed Care Health Plan Appointment Standards Survey Report updated 9/30/2016
- Health Plan Website Accuracy and New Patient Acceptance Rates Survey Report
- MO HealthNet SFY 2014 Managed Care EPSDT Report
- Executive Order 98-12 Department of Social Services and Department of Mental Health Collaboration
- Rate Setting
- Managed Care External Quality Reviews
2021 Annual Technical Report (Note: No Managed Care Organizations are exempt from EQR 2022)
- United Healthcare
- Home State Health
- Healthy Blue
2020 Annual Technical Report (Note: No Managed Care Organizations are exempt from EQR 2021)
- United Healthcare
- Home State Health
- Healthy Blue
2019 Annual Technical Report (Note: No Managed Care Organizations are exempt EQR 2020)
- United Healthcare
- Home State Health
- Missouri Care
- United Healthcare
- Home State Health
- Missouri Care
- United Healthcare
- Home State Health
- Missouri Care
- Managed Care Enrollment Data
- Managed Care Quality Oversight
- 2022 Quality Improvement Strategy
- Missouri Encounter Data Triennial Audit Summary
- Missouri Triennial Financial Audit
- 2021 Quality Improvement Strategy
- Evaluation of 2018 Quality Strategy
- 2018 Quality Improvement Strategy
- Evaluation of 2013 Quality Strategy
- MCO Accreditation Chart
- MCO Ownership Control and Transaction Disclosure Report
MCO Annual Data
- Contracts
Reporting Requirements - October 2022
July 2022 RFP Vendor Library
Vendor Documents
- MO HealthNet Quality Improvement Strategy
- Additional Health Benefit Template
- Marketing Guidance
- In Lieu of Service (ILOS) Application | In Lieu of Service Application
- Member Incentive Program Template
- State Provider Incentive Program Template
- Policies and Procedures Requiring Prior Approval
- Policy Submission Form
- MO HealthNet Acronyms
- MO HealthNet Managed Care Related Eligibility Groups, Attachment 1
- Managed Care Performance Withhold Technical Specifications 2021
- Managed Care Performance Withhold Technical Specifications 2024
- MO MAPS - Operations Manual
- EPSDT Screening Codes and Methodology
- EPSDT Screening Codes by Line Number
- Federally Qualified Health Center and Rural Health Clinic Services
- Delivery Kick Payment Policy
- Travel Distance Standards
- Waivers Operated by the Department of Mental Health (DMH)
- Managed Care Provider Coordination with Local Public Health Agencies
- Community Mental Health Center Reimbursement
- MO HealthNet Managed Care Policy Statements
- MO HealthNet Health Risk Assessment
- MO HealthNet Quality Improvement Strategy
- NICU Payment Policy
- SMHK Member Journey Quarterly Report Template
- CM Member Journey Quarterly Report Template
- Performance Withhold
- Reporting Requirements (Examples)
Reporting Schedules and Templates (Examples)
Managed Care Contract Approved March 21, 2021
Amendments CMS Approved
- Amendment #16 (eff. 1/1/2022) approved 04/18/2023
- Amendment #15 (eff. 10/1/2021) approved 02/15/2023
- Amendment #14 (eff. 7/1/2021) approved 11/30/2022
Secure Exchange Solution (SES) Missouri Medical Passport Program (MMPP)
Contract Effective May 1, 2017 Documentation
- Bidder and Vendor Documents
- Reporting Schedules and Templates
- Reporting Requirements - January 2022
- Reporting Requirements - July 2022
Managed Care Contract Ending April 30, 2017 Amendment Approved by CMS
Managed Care Contract Ending April 30, 2017 Amendments Pending CMS Approval- No amendments pending at this time.
- MO HealthNet Managed Care Contracts Awarded (Contract End Date April 30, 2017)
Contract Ending April 30, 2017 Documentation
MO HealthNet Care Management Innovation and Expansion Request for Information
The summaries of the responses to the MO HealthNet Care Management Innovation and Expansion Request for Information (RFI) released September 11, 2015, with responses due by October 9, 2015. The purpose of the RFI was to allow interested parties an opportunity to provide the State of Missouri with feedback regarding issues related to improving health care quality and increasing the efficiency of health care delivery for low income custodial parents, pregnant women, and children covered by MO HealthNet Managed Care.