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063009 Cms Summary of State MCOs

063009 Cms Summary of State MCOs

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Published by Disability Mom
Do you know who your Medicaid provider is? Do you know if they're a for-profit company or a not-for-profit company? This is a list put out by CMS of all the Medicaid "plans" operated around the country, broken out by state. Most of these are waiver programs. The list is accurate for June 30, 2009.
Do you know who your Medicaid provider is? Do you know if they're a for-profit company or a not-for-profit company? This is a list put out by CMS of all the Medicaid "plans" operated around the country, broken out by state. Most of these are waiver programs. The list is accurate for June 30, 2009.

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Categories:Types, Business/Law
Published by: Disability Mom on Dec 18, 2010
Copyright:Attribution Non-commercial

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12/18/2010

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StatePlan June 30, 2009
 Medicaid Managed Care Program Summary
 Managed Care Entity Reimbursement ArrangementOperating AuthorityGeographic Area Served  Number of  Enrollees
ALMaternity Care ProgramMedical-onlyPIHPRisk-basedCapitation1915(b)Statewide21,324ALPartnership Hospital ProgramMedical-onlyPIHPRisk-basedCapitation1915(a) -1902(a)(4)Statewide518,769ALPatient 1stPCCMFee-For-Service1915(b)Statewide443,327ARConnect CarePCCMFee-For-Service1115Statewide411,351ARNon-Emergency TransportationTransp PAHPRisk-basedCapitation1915(b)Statewide451,863ARTotal Life HealthcarePACERisk-basedCapitationPACE72315, 72319, 72324, 72354, 72365, 72373, 72387, 72396,72401, 72404, 72411, 72414, 72416, 72417, 72419, 72421,72427, 72432, 72433, 72437, 72438, 72442, 72447, 72450,72455, 72465, 72467, 72472, 7247621AZAZ Physicians IPA (Family PlanningExtension)Medicaid MCORisk-basedCapitation1115La Paz, Maricopa, Pima, Yuma604AZAZ Physicians IPA (HP)Medicaid MCORisk-basedCapitation1115LaPaz, Maricopa, Pima, Yuma220,485AZBridgeway (Family Planning Extension)Medicaid MCORisk-basedCapitation1115Yavapai56AZBridgeway Health Solution (HP)Medicaid MCORisk-basedCapitation1115LaPaz, Maricopa, Yuma16,182AZBridgeway Health Solution (PC)Medicaid MCORisk-basedCapitation1115Yavapai2,405AZCare 1st Health PlanMedicaid MCORisk-basedCapitation1115Maricopa49,355AZCare 1st Health Plan (Family PlanningExtension)Medicaid MCORisk-basedCapitation1115Maricopa208AZCochise Co. Dept. of Health Services (PC)Medicaid MCORisk-basedCapitation1115Cochise, Graham, Greenlee938AZDepartment of EconomicSecurity/Childrens Medical and DentalProgram (Family Planning Extension)Medicaid MCORisk-basedCapitation1115Statewide0
 Page 23
 Blank or 0 "Number of Enrollees" indicates Plan had not been implemented as of 6/30/2009* Indicates the structure of the Managed Care Entity is "Other" and not considered a PCCM, MCO, HIO, PIHP, PAHP or PACE
 
StatePlan June 30, 2009
 Medicaid Managed Care Program Summary
 Managed Care Entity Reimbursement ArrangementOperating AuthorityGeographic Area Served  Number of  Enrollees
AZDepartment of EconomicSecurity/Childrens Medical and DentalProgram (HP)Medicaid MCORisk-basedCapitation1115Statewide9,533AZDepartment of EconomicSecurity/Division of DevelopmentalDisabilities (PC)Medicaid MCORisk-basedCapitation1115Statewide21,753AZDepartment of Health Services(Behavioral Health)MH/SUD PIHPRisk-basedCapitation1115Apache, Cochise, Coconino, Gila, Graham, Greenlee, LaPaz,Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz,Yavapai, Yuma104,101AZEvercare Select (PC)Medicaid MCORisk-basedCapitation1115Apache, Coconino, La Paz, Maricopa, Mohave, Navajo, Yuma3,647AZHealth Choice Arizona (Family PlanningExtension)Medicaid MCORisk-basedCapitation1115Apache, Coconino, LaPaz, Maricopa, Mohave, Navajo, Pima,Santa Cruz, Yuma791AZHealth Choice Arizona (HP)Medicaid MCORisk-basedCapitation1115Apache, Coconino, LaPaz, Maricopa, Mohave, Navajo, Pima,Santa Cruz, Yuma177,142AZMaricopa County Health Plan (FamilyPlanning Extension)Medicaid MCORisk-basedCapitation1115Maricopa109AZMaricopa County Health Plan (HP)Medicaid MCORisk-basedCapitation1115Maricopa51,234AZMercy Care Plan (Family PlanningExtension)Medicaid MCORisk-basedCapitation1115Cochise, Graham, Greenlee, Maricopa, Pima994AZMercy Care Plan (HP)Medicaid MCORisk-basedCapitation1115Cochise, Graham, Greenlee, Maricopa, Pima283,456AZMercy Care Plan (PC)Medicaid MCORisk-basedCapitation1115Maricopa8,388AZPhoenix Health Plan/CommunityConnection (Family Planning Extension)Medicaid MCORisk-basedCapitation1115Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pima,Pinal, Yavapai710AZPhoenix Health Plan/CommunityConnection (HP)Medicaid MCORisk-basedCapitation1115Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pima,Pinal, Yavapai174,038AZPima Health System (Family PlanningExtension)Medicaid MCORisk-basedCapitation1115Pima12AZPima Health System (HP)Medicaid MCORisk-basedCapitation1115Pima2,153
 Page 24
 Blank or 0 "Number of Enrollees" indicates Plan had not been implemented as of 6/30/2009* Indicates the structure of the Managed Care Entity is "Other" and not considered a PCCM, MCO, HIO, PIHP, PAHP or PACE
 
StatePlan June 30, 2009
 Medicaid Managed Care Program Summary
 Managed Care Entity Reimbursement ArrangementOperating AuthorityGeographic Area Served  Number of  Enrollees
AZPima Health System (PC)Medicaid MCORisk-basedCapitation1115Pima, Santa Cruz4,210AZPinal County Long Term Care (PC)Medicaid MCORisk-basedCapitation1115Gila, Pinal1,433AZSCANMedicaid MCORisk-basedCapitation1115Maricopa2,591AZUniversity Family Care (Family PlanningExtension)Medicaid MCORisk-basedCapitation1115Cochise, Gila, Graham, Greenlee, Pima, Pinal, Santa Cruz159AZUniversity Family Care (HP)Medicaid MCORisk-basedCapitation1115Cochise, Gila, Graham, Greenlee, Pima, Pinal, Santa Cruz62,763AZYavapai County Long Term Care (PC)Medicaid MCORisk-basedCapitation1115Yavapai1,016CAAccess Dental Plan-LADental PAHPRisk-basedCapitation1915(a)Los Angeles104,353CAAccess Dental Plan-SacramentoDental PAHPRisk-basedCapitation1915(a)Sacramento51,946CAAlameda Alliance for HealthCommercial MCORisk-basedCapitation1915(b), 1932(a)Alameda88,767CAAltaMed Health Services CorporationPACERisk-basedCapitationPACELA622CAAmerican Health Guard-Dental Plan-LADental PAHPRisk-basedCapitation1915(a)Los Angeles16,938CAAnthem Blue Cross Partnership Plan -SacramentoCommercial MCORisk-basedCapitation1915(b), 1932(a)Sacramento86,166CAAnthem Blue Cross Partnership Plan-TPMPCommercial MCORisk-basedCapitation1915(b), 1932(a)Alameda, Contra Costa, Fresno, San Francisco, SanJoaquin, Santa Calra, Stanislaus, Tulare349,162CACaloptima-OrangeHIORisk-basedCapitation1915(b)Orange327,163CACare 1st Health Plan/San DiegoCommercial MCORisk-basedCapitation1915(b), 1932(a)San Diego9,126CACare 1st Health Plan-Dental-LADental PAHPRisk-basedCapitation1915(a)Los Angeles17,632
 Page 25
 Blank or 0 "Number of Enrollees" indicates Plan had not been implemented as of 6/30/2009* Indicates the structure of the Managed Care Entity is "Other" and not considered a PCCM, MCO, HIO, PIHP, PAHP or PACE

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