Medicaid Actuarial Services
This unit provides advanced financial and statistical support for the Bureau relating to Capitation Rates, Risk Adjustment Models and Payment Methodologies.
Unit Responsibilities include:
- Support of Capitation Rate Development and Adjustment
- Management of External Actuarial Service Contracts
- Monitoring Medicaid Program Changes
- Trend Analysis
- Rate Impact Analysis
For Institutional Reimbursement rates, please click here.
SMMC Capitation Information
Managed Medical Assistance (MMA)
Long-Term Care (LTC)
Medicare Dual Eligible Special Needs Plans (D-SNPs)
Special Needs Plan Revenue and Expense Schedule Statement Template Tool [142KB Excel]
Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Medicaid Covered Services [79KB PDF]