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Technical Assistance

Medicaid Managed Care – Individualized Technical Assistance for States

Direct technical assistance is available from the Centers for Medicare & Medicaid Services (CMS) to assist state Medicaid agencies in developing, enhancing, implementing, and evaluating managed care programs.

Examples of areas where states may request direct technical support include:

Managed Care Program Planning & Procurement

  • Federal managed care authorities and waiver applications
  • Rate setting and risk adjustment
  • Managed care organization (MCO) contracting and purchasing
  • Stakeholder engagement

Access, Quality and MCO Financial Monitoring and Oversight

  • Developing standards and measuring provider network adequacy
  • Quality measurement, reporting, and improvement
  • MCO financial oversight
  • Monitoring and enforcing MCO compliance with contract provisions
  • Ensuring program integrity and preventing fraud and abuse in MCOs

Benefit Design & Specialized Services and Populations

  • Behavioral health services
  • Behavioral and physical health integration
  • Dual eligibles and managed care
  • Managed long term services and supports
  • Other, i.e. dental, transportation, pharmacy

Beneficiary Enrollment, Education, and Rights

  • Beneficiary education/information
  • Contracting with enrollment brokers
  • Developing and implementing auto-enrollment/auto-assignment strategies
  • Managing grievances and appeals


  • Analyzing data for performance measurement
  • Developing or implementing information technology and systems
  • Encounter data collection and validation

To request technical assistance, states should reach out to: