Centers for Medicare & Medicaid Services
5 indexed reports
Washington Medicaid Managed Care Medical Loss Ratio Audit
CMS identified eight findings requiring correction, but none resulted in an MLR recalculation below the 85% remittance threshold; the audit identified operational improvements and oversight enhancemen...
Ohio Medicaid Managed Care Medical Loss Ratio Audit
While no remittances were required based on the findings, the audit identified multiple areas for improvement in Ohio’s oversight and reporting processes to ensure compliance with federal requirements...
Oklahoma Focused Program Integrity Review Final Report
CMS supports Oklahoma’s efforts and encourages further improvements in program integrity. The review identified four observations for the state’s attention but no non-compliance findings that pose a r...
Kansas Medicaid and CHIP Eligibility Determinations Audit
The audit found that Kansas generally complies with eligibility determination requirements but identified significant areas for improvement, especially in documentation, timely case closure, and resou...
Oregon Medicaid Managed Care Medical Loss Ratio Audit
The audit identified areas for improvement in Oregon's Medicaid managed care MLR reporting and oversight processes. While no immediate remittance was required, implementing the recommendations will en...