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CMS lax in oversight of states’ Medicaid managed-care rates, GAO says
Modern Healthcare

The CMS needs to be more consistent in its review of how states set rates for Medicaid managed care, according to the Government Accountability Office.

States under current law must ensure the rates insurance companies charge for managed care are fair and certified by an independent insurance actuary. Each state is required to submit its rate-setting methodology, including a description of the data used, to the CMS for approval.