Today, the Centers
for Medicare & Medicaid Services (CMS) released the 2020-2021 Medicaid
Managed Care Rate Development Guide for use by states in setting their
capitation rates between July 1, 2020 and June 30, 2021 for managed care
programs subject to the actuarial soundness requirements.
This guide includes
information that states must include in their rate certifications to ensure
that CMS can determine compliance with the applicable provisions in federal
statute. A new addition to this year’s rate guide is the national roll-out
of an accelerated rate review process. A new appendix to the rate guide
summarizes the accelerated rate review process, participation criteria, and
documentation requirements. In particular, states that elect to use the
accelerated rate review process must submit a Rate Development Summary
identifying key elements.
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