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Guidance
- Medicaid and CHIP Managed Care Final Rules
- Monitoring and Oversight
- Medicaid and CHIP Managed Care Reporting
- In Lieu of Services and Settings
- Medical Loss Ratio
- State Directed Payments
- Rate Review and Rate Guides
- Contract Review
- Parity for Mental Health and Substance Use Disorder Benefits
- Encounter Data
- Additional Guidance
MLR Summary Reports
The MLR Summary Reports provide plan-specific MLRs for Medicaid managed care programs. The MLR summary report data include MLRs for MCOs, PIHPs, and PAHPs submitted by states under 42 CFR § 438.74.
Plan-specific data include:
- Plan name
- Reporting period start and end dates
- MLR numerator
- MLR denominator
- Member months
- Adjusted MLR
- Remittance amount owed by plan
The report also provides:
- State
- Program name
- Program type
- Eligibility group (if applicable)
How to Access the Files
This page provides links to Medicaid MLR Report data on Data.Medicaid.gov, where you can filter, sort, share, and download the data. To download data as an Excel file, first follow the links on this page to navigate to your dataset. Select the “Export” button in the top right of the data, then select “CSV for Excel” from the download list.