Thank you to our MO HealthNet Managed Care Health Plans for providing quality care to Missourians. We appreciate your dedication to serving our Medicaid participants while following our guiding principles.
Contract Information
- Managed Care Contract Effective 07/01/2022 (CMS Approved 10/05/2023)
- Amendment #001 - Effective 07/01/2022 (CMS Approved 10/11/2023)
- Amendment #002 - Effective 10/01/2022 (CMS Approved 10/20/2023)
- Amendment #003 - Effective 01/01/2023 (CMS Approved 05/20/2024)
- Amendment #004 - Effective 07/01/2023 - Renewal Stop Gap Contract (CMS Approved 05/20/2024)
- Amendment #005 - Effective 07/01/2023 (CMS Approved 05/20/2024)
- Amendment #006 - Effective 10/01/2023 (CMS Approved 05/20/2024)
- Amendment #007 - Effective 01/01/2024 (CMS Approved 08/19/2025)
- Amendment #008 - Effective 07/01/2024 (CMS Approved 08/19/2025)
- Amendment #009 - Effective 10/01/2024 (CMS Approved 08/19/2025)
- Amendment #010 - Effective 01/01/2025 (CMS Approved 08/19/2025)
- Amendment #011 - Effective 07/01/2025 (Pending CMS Approval)
- Amendment #012 - Effective 07/01/2025 (Pending CMS Approval)
- Amendment #013 – Effective 10/01/2025 (Pending CMS Approval)
- Amendment #014 – Effective 01/01/2026 (Pending CMS Approval)
- Amendment #015 – Effective 01/01/2026 – Rate Adjustment Amendment (Pending CMS Approval)
- Reporting Templates & Vendor Documents
Quality Oversight
- 2024 Quality Improvement Strategy
- Encounter Edits Descriptions
- Evaluation of 2021 Quality Improvement Strategy
- Managed Care Encounter Data Guide
- Managed Care Encounter Data Issue Form
- Managed Care Organization Accreditation Chart
- Missouri Triennial Encounter Audit – 6-25-24
- MCO Ownership Control & Transaction Disclosure Report
- Provider Network Adequacy Standards Report
Annual Reports
- 2024 CHIP & Show Me Healthy Babies Annual Report
- 2024 CHIP & Show Me Healthy Babies Appendices
- Annual Summary for Enrollment Data (SFY 2026)
The State of Missouri provides these federal documents as a public resource. As this is a third-party publication, the State cannot alter or adjust the file to meet current WCAG 2.2 Level AA accessibility standards. To request an accessible version or an equivalent format, please contact altformatrequest@cms.hhs.gov or visit the CMS website.
Current External Quality Reviews
View All Current and Archived Reports on the External Quality Reviews webpage
- 2025 Annual Technical Report
- Note: No Managed Care Organizations are exempt from EQR 2025
- Secret Shopper
- Prior Authorization Audit
United Healthcare
- 2025 UHC Compliance
- 2025 UHC Performance Measures
- 2025 UHC Improvement Projects
- 2025 UHC Care Management
- 2025 UHC Network Adequacy
Home State Health
- 2025 HSH Compliance
- 2025 HSH Performance Measures
- 2025 HSH Improvement Projects
- 2025 HSH Care Management
- 2025 HSH Network Adequacy
Healthy Blue
- 2025 HB Compliance
- 2025 HB Performance Measures
- 2025 HB Improvement Projects
- 2025 HB Care Management
- 2025 HB Network Adequacy
Show Me Healthy Kids
Managed Care Network Access
Data related to which healthcare providers and specialists are currently contracted with each managed care organization
More Information
- Calendar of Events
- History of MO HealthNet Managed Care
- Home State Health Providers - Care Management Flyer
- Managed Care Provider Toolkit
- Managed Care Network Access
- Mental Health Parity Report
- MissouriBUYS Statewide Procurement System
- Missouri Medicaid Audit & Compliance
- MO HealthNet News
- OA Award Bid & Contract Document Search
- Provider Forms
- Quality Assurance and Improvement Committee
- Quality of Care External Quality Review
- Sign up for MO HealthNet News
