Tsev Cov Ntaub Ntawv & Cov Txheeb Xyuas Cov Ntaub Ntawv thiab Cov Txheeb Xyuas ntawm DHCS Cov Ntawv Qhia Txog Nyiaj Txiag ntawm Medi-Cal Managed Care

Medi-Cal Managed Care Cov Ntawv Qhia Txog Nyiaj Txiag

Capitated Rates Development Division tau tshaj tawm ntau yam kev tshaj tawm thiab cov ntaub ntawv ntsig txog Medi-Cal cov phiaj xwm kev noj qab haus huv uas tswj hwm, suav nrog cov nqi peev txheej, phau ntawv qhia, cov ntawv pov thawj, cov kev tshawb fawb txog tus nqi capitation, cov txheej txheem txhim kho tus nqi thiab lwm yam ntaub ntawv ntsig txog.

Medi-Cal Tswj Tus Nqi Kho Mob

** Txuas mus rau California Kev Noj Qab Haus Huv thiab Kev Pabcuam Tib Neeg (CHHS) Open Data Portal Lub Vev Xaib.

Rate Certifications

CY 2021 Rate Certification Report
CY 2021 Rate Certification Report - UIS Amendment
CY 2022 Rate Certification Report
Daim Ntawv Qhia Txog Kev Pom Zoo Tus Nqi CY 2022 - Hloov Kho
Daim Ntawv Qhia Txog Kev Pom Zoo Txog Tus Nqi CY 2022 - Kev Hloov Kho UIS
CY 2023 Rate Certification Report
Daim Ntawv Qhia Txog Kev Pom Zoo Tus Nqi CY 2023 - Hloov Kho
CY 2024 Rate Certification Report
CY 2024 Rate Certification Report – Amended
CY 2025 Rate Certification Report
Daim Ntawv Qhia Txog Kev Pom Zoo Txog Tus Nqi CY 2026

Cov Nqi Kawm Tshwj Xeeb

CMS Annual MLR Report

These pages contain results related to 42 CFR 438.74(a) for the State of California’s Medi-Cal Managed Care Plans and Medi-Cal Dental Managed Care Plans.

Lub Xeev Saib Xyuas Kev Kho Mob Loss Ratio Work Plan

Qhov no sawv cev rau Kev Npaj Ua Haujlwm rau 1915(b) CalAIM Waiver, STC A11 uas tau xa mus rau CMS thaum Lub Kaum Ib Hlis 30, 2022.

Lub Xeev Saib Xyuas Kev Kho Mob Loss Ratio Work Plan

Nco tseg: Txoj Kev Npaj Ua Haujlwm no raug hloov pauv thiab yuav raug kho yog tias CMS thov DHCS los hloov kho.

California Risk Mitigation Evaluation Design Design

CMS tau pom zoo rau CalAIM Tshooj 1115 ua qauv qhia thiab CalAIM Tshooj 1915(b) zam rau lub Kaum Ob Hlis 29, 2021, ob qho tib si pib txij lub Kaum Ob Hlis 31, 2026.

CalAIM Tshooj 1115 Qhia Txog
CMS Daim Ntawv Pom Zoo Rau Kev Tsim Qauv Kev Ntsuam Xyuas Kev Txo Kev Pheej Hmoo Hauv CA

CMS Periodic Audit Reports

These links contain results related to 42 CFR 438.602(e) for the State of California’s Medi-Cal Managed Care and Medi-Cal Dental Managed Care Plans.

Transitional Rent Resources

Transitional Rent Payment Methodology (Lub Kaum Hli 2025)
CY 2026 Cov Sijhawm Hloov Sijhawm Reimbursable Ceilings Tus Nqi Teem sijhawm

Medi-Cal Managed Care Cov Ntawv Qhia Txog Nyiaj Txiag​​

Medi-Cal Tswj Tus Nqi Kho Mob​​

Rate Certifications​​

Cov Nqi Kawm Tshwj Xeeb​​

CMS Annual MLR Report​​

Lub Xeev Saib Xyuas Kev Kho Mob Loss Ratio Work Plan​​

California Risk Mitigation Evaluation Design Design​​

CMS Periodic Audit Reports​​

Transitional Rent Resources​​