CMS Enrollment Report

2009 MEDICAID MANAGED CARE ENROLLMENT REPORT SUMMARY STATISTICS AS OF JUNE 30, 2009
This report is composed annually by the Finance, Systems, and Budget Group (FSBG) of the Centers for Medicare & Medicaid Services (CMS). The Enrollment Report profiles Medicaid managed care programs on a plan-specific basis as of June 30, 2009. County level data is not collected. The information was collected from State Medicaid agencies and CMS Regional Offices. Data is presented for all States, the District of Columbia, Puerto Rico, and the Virgin Islands. Data is not presented for the following territories: Guam, Northern Mariana Islands, and American Somoa. Special Thanks to Loan Swisher and Carolyn Lawson of DSG for developing this publication and Joseph Del Pilar of DSG for designing this publication. Please Contact Carolyn Lawson at 410-786-0704; E-mail: carolyn.lawson@cms.hhs.gov or Loan Swisher at 410-786-4650; E-mail: loan.swisher@cms.hhs.gov, if you have any questions concerning this report.
Medicaid Managed Care Enrollment Report as of June 30, 2009
Table of Contents
Managed Care Trends (2000-2009) and National Breakout of Managed Care Entities and Enrollment charts ....................................... Page 1 Total Medicaid Population (in percentages) Distribution by Year: Managed Care versus Other from 2004-2009 .................... Page 2 Total Medicaid Population (in millions) Distribution by Year: Managed Care versus Other from 2004-2009 ..................... Page 3 Medicaid Managed Care Penetration Rates by State.............................. Page 4 Managed Care Entity Type Enrollment by State .................................... Page 5 Number of Managed Care Entities by State ........................................... Page 6 Top 20 Medicaid Managed Care States ................................................. Page 7 Regional Breakout of Medicaid Managed Care Enrollment & States with Comprehensive Health Care Reform Demonstrations ...... Page 8 Prepaid Ambulatory Health Plans (PAHPs) and Enrollment by State ... Page 9 Prepaid Inpatient Health Plans (PIHPs) and Enrollment by State .......... Page 10 Medicaid Dual Eligible Enrollment by State .......................................... Page 11 Dual Eligible Enrollment by Managed Care Entity Type ...................... Page 12 Dual Eligible Enrollment by Plan ........................................................... Page 13 Medicaid Managed Care Enrollment Plan level data by State .............. Page 22 Facts Sheet (Major changes from 6/30/2008-6/30/2009)Page 75 New Medicaid Managed Care PlansPage 77 Terminated Medicaid Managed Care Plans.Page 79 GlossaryPage 80
NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT AS OF JUNE 30, 2009
MANAGED CARE TRENDS

YEAR 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 TOTAL MEDICAID POPULATION 50,471,859 47,142,791 45,962,271 45,652,642 45,392,325 44,355,955 42,740,719 40,147,539 36,562,567 33,690,364 MANAGED CARE POPULATION 36,202,281 33,427,582 29,463,098 29,830,406 28,575,585 26,913,570 25,262,873 23,117,668 20,773,813 18,786,137 OTHER POPULATION 14,269,578 13,715,209 16,499,173 15,822,236 16,816,740 17,442,385 17,477,846 17,029,871 15,788,754 14,904,227 % MANAGED CARE ENROLLMENT 71.73% 70.91% 64.10% 65.34% 62.95% 60.68% 59.11% 57.58% 56.82% 55.76%
These figures represent point-in-time enrollment as of June 30th for each reporting year. The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. This table also provides unduplicated national figures for the Total Medicaid population and Other population. The statistics also include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
NATIONAL BREAKOUT OF MANAGED CARE ENTITIES AND ENROLLMENT AS OF JUNE 30, 2009 MANAGED CARE ENTITY TYPE # OF PLANS # OF ENROLLEES
Health Insuring Organization Commercial Managed Care Organization Medicaid-only Managed Care Organization Primary Care Case Management Prepaid Inpatient Health Plan Prepaid Ambulatory Health Plan Program of ALL-inclusive Care for the Elderly Other TOTAL
4 159 159 36 152 60 67 9 646
601,662 10,284,082 13,176,581 7,275,241 8,593,773 7,866,947 17,091 2,113,534 49,928,911
This table provides duplicated figures by plan type. The total number of enrollees include 13,726,630 individuals who were individuals who were enrolled in more than one managed care plan. It also includes individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

Total Annual Medicaid Population Distribution by Year: Managed Care v. Other as of June 30, 2009
Percent of Total Medicaid Population
39.32%
37.05%
34.66%
35.90%
29.09%
28.27%
100.00% 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% 2004 2005 2006
60.68% 62.95% 65.34% 64.10% 70.91% 71.73%
Other Managed Care
Year
2007
2008
2009
NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

Total Annual Medicaid Population Distribution by Year: Managed Care v. Other as of June 30, 2009
Total Medicaid Population (in millions)
60.00
14.27
50.00
17.44
13.72 16.82 15.82 16.50
40.00
Other Managed Care
30.00
26.91 28.58 29.83 29.46 33.43
36.20
20.00
10.00
0.00 2004 2005 2006 2007
Year
2008
2009
* Note: Numbers may not add up to totals due to rounding.
MEDICAID MANAGED CARE ENROLLMENT AS OF JUNE 30, 2009 STATE MEDICAID MANAGED CARE PERCENT IN ENROLLMENT ENROLLMENT MANAGED CARE ALABAMA 812,220 540,093 66.50% ALASKA 101,702 0 0.00% ARIZONA 1,223,271 1,096,365 89.63% ARKANSAS 645,389 511,014 79.18% CALIFORNIA 6,955,761 3,632,547 52.22% COLORADO 467,556 444,819 95.14% CONNECTICUT 455,878 342,784 75.19% DELAWARE 170,562 126,089 73.93% DISTRICT OF COLUMBIA 153,779 150,406 97.81% FLORIDA 2,426,010 1,600,550 65.97% GEORGIA 1,385,721 1,274,823 92.00% HAWAII 235,203 228,174 97.01% IDAHO 198,000 166,524 84.10% ILLINOIS 2,320,700 1,278,200 55.08% INDIANA 961,986 711,636 73.98% IOWA 397,823 329,897 82.93% KANSAS 297,290 257,464 86.60% KENTUCKY 768,777 638,083 83.00% LOUISIANA 1,006,842 692,048 68.73% MAINE 280,148 178,353 63.66% MARYLAND 787,366 620,024 78.75% MASSACHUSETTS 1,227,109 731,123 59.58% MICHIGAN 1,629,959 1,447,373 88.80% MINNESOTA 675,149 426,009 63.10% MISSISSIPPI 673,630 512,796 76.12% MISSOURI 895,077 883,423 98.70% MONTANA 84,785 56,434 66.56% NEBRASKA 214,699 179,512 83.61% NEVADA 213,440 178,711 83.73% NEW HAMPSHIRE 124,498 96,553 77.55% NEW JERSEY 968,598 725,614 74.91% NEW MEXICO 464,852 344,977 74.21% NEW YORK 4,422,121 2,926,950 66.19% NORTH CAROLINA 1,442,396 1,012,474 70.19% NORTH DAKOTA 60,111 40,605 67.55% OHIO 1,951,511 1,374,520 70.43% OKLAHOMA 625,546 553,385 88.46% OREGON 474,835 418,096 88.05% PENNSYLVANIA 1,920,134 1,576,523 82.10% PUERTO RICO 1,013,486 977,648 96.46% RHODE ISLAND 177,981 110,584 62.13% SOUTH CAROLINA 763,225 763,225 100.00% SOUTH DAKOTA 107,196 85,476 79.74% TENNESSEE 1,230,750 1,230,750 100.00% TEXAS 3,343,241 2,161,210 64.64% UTAH 238,358 204,793 85.92% VERMONT 156,503 137,385 87.78% VIRGIN ISLANDS 7,728 0 0.00% VIRGINIA 814,820 520,773 63.91% WASHINGTON 1,103,291 949,263 86.04% WEST VIRGINIA 325,653 149,694 45.97% WISCONSIN 1,004,704 606,509 60.37% WYOMING 64,489 0 0.00% TOTALS 50,471,859 36,202,281 71.73% The unduplicated Medicaid enrollment figures include individuals in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards. The unduplicated managed care enrollment figures includes enrollees receiving comprehensive and limited benefits. ROW NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 4
NUMBER OF MANAGED CARE ENTITY ENROLLEES BY STATE AS OF JUNE 30, 2009 Commercial STATE HIO MCO Medicaid-only MCO PCCM PIHP PAHP PACE OTHER
Alabama 0 0 0 443,327 540,093 0 0 0 Alaska 0 0 0 0 0 0 0 0 Arizona 0 0 1,096,365 0 104,101 0 0 0 Arkansas 0 0 0 411,351 0 451,863 21 0 California 601,662 2,996,873 7,507 0 157 447,661 2,311 0 Colorado 0 0 44,247 22,426 463,464 0 1,421 0 Connecticut 0 83,069 259,547 168 0 0 0 0 Delaware 0 0 117,602 0 0 0 0 8,487 Dist of Columbia 0 0 96,639 0 3,593 50,174 0 0 Florida 0 684,903 249,331 455,877 700,431 341,100 329 9,392 Georgia 0 0 838,344 108,619 0 1,274,823 0 0 Hawaii 0 160,120 68,037 0 0 0 17 0 Idaho 0 0 0 166,524 0 130,338 0 0 Illinois 0 133,200 44,700 1,100,300 0 0 0 0 Indiana 0 455,565 191,413 64,189 0 0 0 469 Iowa 0 0 0 170,659 329,897 0 55 0 Kansas 0 0 141,000 24,050 243,352 243,352 227 0 Kentucky 0 0 159,005 304,973 0 638,083 0 0 0 0 0 729,219 0 0 119 0 Louisiana Maine 0 0 0 178,353 0 0 0 0 Maryland 0 0 589,540 0 0 30,346 138 0 Massachusetts 0 147,546 288,628 284,404 304,821 0 2,178 0 Michigan 0 0 1,088,815 0 1,447,373 0 387 0 Minnesota 0 375,046 50,963 0 0 0 0 0 Mississippi 0 0 0 0 0 512,796 0 0 Missouri 0 0 401,314 0 0 481,926 183 0 Montana 0 0 0 371 0 368 24 0 Nebraska 0 36,119 0 38,623 0 0 0 179,512 Nevada 0 59,381 46,921 0 0 178,711 0 0 New Hampshire 0 0 0 0 0 96,553 0 0 New Jersey 0 268,734 456,880 0 0 0 31 0 New Mexico 0 275,942 69,035 0 312,498 0 376 0 New York 0 862,624 2,013,976 16,639 24,353 0 3,210 6,148 North Carolina 0 0 0 998,909 72,734 0 50 0 0 North Dakota 0 0 0 29,339 0 2,427 25 Ohio 0 0 1,373,828 0 0 0 692 0 Oklahoma 0 0 0 412,473 0 553,385 49 0 Oregon 0 35,501 303,046 12,207 399,545 410,448 555 0 Pennsylvania 0 965,188 0 262,583 1,442,729 457,520 1,637 0 Puerto Rico 0 959,059 0 0 505,302 0 0 0 164 Rhode Island 0 46,216 74,027 0 0 41,717 0 South Carolina 0 0 341,782 90,136 0 763,367 407 0 South Dakota 0 0 0 85,476 0 0 0 0 Tennessee 0 0 1,159,089 0 143,322 0 309 1,909,526 Texas 0 210,066 1,218,036 732,219 306,513 54,794 889 0 Utah 0 0 0 58,484 273,016 176,036 0 0 Vermont 0 0 137,385 0 0 0 76 0 Virgin Islands 0 0 0 0 0 0 0 0 Virginia 0 312,878 153,794 54,101 0 520,773 315 0 Washington 0 581,587 0 4,495 949,263 8,386 319 0 West Virginia 0 149,694 0 14,747 0 0 0 0 Wisconsin 0 484,771 95,785 0 27,216 0 577 0 Wyoming 0 0 0 0 0 0 0 0 TOTALS 601,662 10,284,082 13,176,581 7,275,241 8,593,773 7,866,947 17,091 2,113,534 This table provides duplicated figures that include enrollees receiving comprehensive and limited benefits. Total number of enrollees includes those who were enrolled in more than one managed care plan. Figures also include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
Page 5
NUMBER OF MANAGED CARE ENTITIES BY STATE AS OF JUNE 30, 2009 STATE

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
HIO
0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Commercial MCO
0 0 0 0 23 0 1 0 0 22 0 4 0 1 4 0 0 0 0 0 0 2 0 6 0 0 0 1 1 0 2 5 21 0 0 0 0 2 11 10 2 0 0 0 6 0 0 0 3 8 3 21 0 159
Medicaid-only MCO
0 0 29 0 2 2 2 2 3 5 3 1 0 2 1 0 2 1 0 0 7 2 14 3 0 6 0 0 1 0 3 1 13 0 0 7 0 13 0 0 1 6 0 6 13 0 1 0 2 0 0 5 0 159
PCCM
1 0 0 1 0 1 1 0 0 1 1 0 1 1 2 1 1 1 1 1 0 1 0 0 0 0 1 1 0 0 0 0 4 2 1 0 2 1 1 0 0 1 1 0 1 1 0 0 1 1 1 0 0 36
PIHP
2 0 1 0 1 6 0 0 1 26 0 0 0 0 0 1 1 0 0 0 0 1 18 0 0 0 0 0 0 0 0 1 17 1 0 0 0 9 38 2 0 0 0 2 1 11 0 0 0 1 0 11 0 152
PAHP
0 0 0 1 13 0 0 0 1 10 1 0 2 0 0 0 1 1 0 0 5 0 0 0 1 1 1 0 1 1 0 0 0 0 1 0 1 8 2 0 1 3 0 0 1 1 0 0 1 1 0 0 0 60
PACE
0 0 0 1 5 3 0 0 0 2 0 1 0 0 0 1 2 0 1 0 1 6 4 0 0 1 1 0 0 0 2 1 5 2 1 2 1 1 10 0 1 2 0 1 2 0 1 0 4 1 0 1 0 67
OTHER
0 0 0 0 0 0 0 1 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 9
TOTALS
Page 6
MEDICAID MANAGED CARE ENROLLMENT AS OF 6/30/09

STATES 1-10 Rank 1 2 3 4 5 6 7 8 9 10 States Waiver Type 1915(b), 1932(a), 1915(a), PACE California 1115(a), 1915(a), PACE New York 1915(b), 1932(a), 1915(a), 1915(b)/(c), PACE Texas 1915(b), 1115(a), 1915(b)/(c), 1915(a)/(c), PACE Florida 1915(b), 1915(a), 1902(a)(70), PACE Pennsylvania 1915(b), PACE Michigan 1932(a), PACE Ohio 1932(a), 1915(a) Illinois 1932(a), 1902(a)(70) Georgia 1115(a), PACE Tennessee Subtotal National Managed Care Grand Total Percentage Managed Care Enrollment 3,632,547 2,926,950 2,161,210 1,600,550 1,576,523 1,447,373 1,374,520 1,278,200 1,274,823 1,230,750 18,503,446 36,202,143 51.11%
STATES 11-20 Arizona 1115(a) 1,096,365 North Carolina 1915(b)/(c), 1932(a), PACE 1,012,474 Puerto Rico 1915(a) 977,648 1915(b), 1932(a), PACE 949,263 Washington 1915(b), 1902(a)(70), PACE 883,423 Missouri 1915(b), 1932(a), 1902(a)(70), PACE 763,225 South Carolina 1115(a), PACE 731,123 Massachusetts 1915(b), 1932(a), PACE 725,614 New Jersey 1915(b), 1115(a) 711,636 Indiana 1932(a), PACE 692,048 Louisiana Subtotal 8,542,819 National Managed Care Grand Total 36,202,143 Percentage 23.60% The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. 11 12 13 14 15 16 17 18 19 20
REGIONAL BREAK-OUT OF MEDICAID MANAGED CARE ENROLLMENT AS OF JUNE 30, 2009 REGION MEDICAID ENROLLMENT 2,422,117 6,411,933 4,172,314 9,502,729 8,544,009 6,085,870 1,804,889 1,022,495 8,627,675 1,877,828 50,471,859 MANAGED CARE ENROLLMENT 1,596,782 4,630,212 3,143,509 7,572,794 5,844,247 4,262,634 1,650,296 832,127 5,135,797 1,533,883 36,202,281 % REGION BENEFICIARIES ENROLLED IN MANAGED CARE 65.93% 72.21% 75.34% 79.69% 68.40% 70.04% 91.43% 81.38% 59.53% 81.68% 71.73% % NATIONAL MANAGED CARE ENROLLMENT 4.41% 12.79% 8.68% 20.92% 16.14% 11.77% 4.56% 2.30% 14.19% 4.24% 100.00%
I - Boston II - New York III - Philadelphia IV - Atlanta V - Chicago VI - Dallas VII - Kansas City VIII - Denver IX - San Francisco X - Seattle TOTALS
The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. This table also provides unduplicated Medicaid enrollment figures by region. The enrollment figures include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
STATES WITH COMPREHENSIVE HEALTH CARE REFORM DEMONSTRATIONS AS OF JUNE 30, 2009
STATE Arizona Arkansas Delaware Florida Hawaii Indiana Kentucky Maryland Massachusetts Minnesota New York Oklahoma Oregon Rhode Island Tennessee Utah Vermont TOTALS MEDICAID ENROLLMENT 1,223,271 645,389 170,562 2,426,010 235,203 961,986 768,777 787,366 1,227,109 675,149 4,422,121 625,546 474,835 177,981 1,230,750 238,358 156,503 16,446,916 EXPANSION ENROLLMENT 183,789 3,376 24,550 225,749 26,277 44,828 0 30,346 115,929 68,557 383,247 0 25,374 20,428 30,667 24,022 41,967 1,249,106 MANAGED CARE ENROLLMENT 1,096,365 511,014 126,089 1,600,550 228,174 711,636 638,083 620,024 731,123 426,009 2,926,950 553,385 418,096 110,584 1,230,750 204,793 137,385 12,271,010 % ENROLLED IN MANAGED CARE 89.63% 79.18% 73.93% 65.97% 97.01% 73.98% 83.00% 78.75% 59.58% 63.10% 66.19% 88.46% 88.05% 62.13% 100.00% 85.92% 87.78% 74.61%
The unduplicated managed care enrollment figures include enrollees receiving comprehensive benefits and limited benefits. This table also provides unduplicated Medicaid and Expansion enrollment figures. The enrollment figures include individuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
Page 8
Number of Prepaid Ambulatory Health Plans (PAHPs) and Enrollment by State as of June 30, 2009
Medicalonly Medicalonly Enrollees Mental Health Substance Use Mental Dental Disorders Health Substance Dental Enrollees Enrollees Enrollees Use Disorders Transportation Disease Transportation Enrollees Management
1 13 447,661 1 2 71,107 2 182,199 1 1 1 1,030 1 243,352 1 5 30,346 1 1 1 1 512,796 481,926 178,711 1 1 1 1 15,615 7 394,833 1 1 1 142 41,717 2 763,225 1 1 1 176,036 520,773 1 9 102,625 1 243,352 1 15,615 24 1,195,718 14 6,079,492 11 8,386 230,145 54,794 406,732 1 50,788 553,385 96,553 2,427 368 638,083 1 129,308 50,174 70,965 1,274,823 5 16,829 451,863
State
Arkansas California District of Columbia Florida Georgia Idaho Kansas Kentucky Maryland Montana Mississippi Missouri Nevada New Hampshire North Dakota Oklahoma Oregon Pennsylvania Rhode Island South Carolina Texas Utah Virginia Washington Totals
Disease Management Enrollees
Page 9
Number of Prepaid Inpatient Health Plans (PIHPs) and Enrollment by State as of June 30, 2009
State Alabama Arizona California Colorado District of Columbia Florida Iowa Kansas Massachusetts Michigan New Mexico New York North Carolina Oregon Pennsylvania Puerto Rico Tennessee Texas Utah Washington Wisconsin Totals
# of Medicalonly PIHPs 2
Medical-only Enrollees 540,093
# of Mental Health MH PIHP # of MH & MH & SUD # of SUD (MH) PIHPs Enrollees SUD PIHPs Enrollees PIHPs
SUD # of Long Term Long Term Care Enrollees Care PIHPs Enrollees
1 1 1 1 6 15,157 3,593 115,980 5 569,329 1 1 18 1 1,447,373 312,498 5 157 448,307
104,101
15 329,897 1 304,821 243,352
15122
17 1 9 4 1 2 203 71,661 71,454 9 1 17 818,141 49 201,562 949,263 2 4,328,034 44 905 3,138,460 1 243,352 9 41 399,545 34 2 1 1 1,442,526 505,302 71,661 306,513 72,734
24,353
26,311 65,786
Page 10
State
DUAL ELIGIBLE ENROLLMENT AS OF JUNE 30, 2009 Medicaid Dual Eligibles

185,738 12,501 137,195 107,520 981,725 68,718 83,246 25,437 19,462 544,958 234,817 28,476 25,000 516,032 128,779 72,528 64,358 152,054 162,278 84,539 94,159 233,181 228,609 116,451 147,884 160,535 18,904 32,875 32,322 24,891 184,158 60,067 643,204 279,230 13,385 267,085 98,219 82,148 367,192 217,652 34,461 128,711 17,914 257,156 559,954 23,136 32,384 154,209 136,149 69,065 160,867 9,050 8,520,568
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming National Total
This table provides an unduplicated number of Medicaid dual eligibles receiving full or partial Medicaid benefits.
Page 11
DUAL ELIGIBLE ENROLLMENT BY MANAGED CARE ENTITY TYPE AS OF JUNE 30, 2009
STATE
Arizona Arkansas California Colorado Dist. of Columbia Florida Georgia Hawaii Idaho Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Minnesota Missouri Mississippi Nebraska Nevada New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina Tennessee Texas Utah Vermont Virginia Washington Wisconsin TOTALS
HIO
MANAGED CARE ENTITY TYPES MCO PCCM PIHP

93,768 82,215 2,788 251 21,668 25,313
PAHP
45,645 14,886 11,048 95 129,559 1,030 33,252 88,914
PACE
19 2,068 1,356 319 13 3 225 97 129 2,047 370 152
OTHER
113,960
4,786
53,278 17 16,776
294
15,822
12,557 153 49,553
32,222 33,252
69,166 20,271 31,345 5,291 38,060 1,019 46,957 20,917 13,241 98,219 48,956 50,955 128,711 14,534 106,372 879,402
19,557 28 355 2,626 28 20 579 46 555 1,540 153 395 309 826 72 296 304 499 15,429
30,569 2,581 216,417 187,246 86,354 14,832 519 9,958 893,649
905 626 8,337 4,621
52,344 188,192 33,498 11,056 1,017 20,789 97,637 36,316 610,552
193,121
113,960
83,073
212,972
This table provides duplicated figures that include enrollees receiving comprehensive and limited benefits. Total number of enrollees includes those who were enrolled in more than one managed care plan. Figures also include invididuals enrolled in State health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
Page 12
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 State AR AR AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Plan Total Life Healthcare Non-Emergency Transportation AZ Physicians IPA (HP) Bridgeway Health Solution (HP) Bridgeway Health Solution (PC) Care 1st Health Plan Cochise Co. Dept. of Health Services (PC) Department of Economic Security/Division of Developmental Disabilities (PC) Evercare Select (PC) Health Choice Arizona (HP) Maricopa County Health Plan (HP) Mercy Care Plan (HP) Mercy Care Plan (PC) Phoenix Health Plan/Community Connection (HP) Pima Health System (HP) Pima Health System (PC) Pinal County Long Term Care (PC) SCAN University Family Care (HP) Yavapai County Long Term Care (PC) Access Dental Plan-LA Access Dental Plan-Sacramento Alameda Alliance for Health AltaMed Health Services Corporation American Health Guard-Dental Plan-LA Anthem Blue Cross Partnership Plan - Sacramento Anthem Blue Cross Partnership Plan-TPMP Caloptima-Orange Care 1st Health Plan/San Diego Care 1st Health Plan-Dental-LA Central Coast Alliance For Health Coalition of Elders Independence dba Center for Elders Independence Community Dental Services/Sacramento Community Dental Services-LA Community Eldercare of San Diego dba St. Paul's PACE Community Health Group Partnership Plan-San Diego Contra Costa Health Plan Health Net Community Solutions, Inc. - Sacramento Health Net Community Solutions, Inc.-San Diego Health Net Community Solutions, Inc.-TPMP Health Net of CA-Dental-LA Health Net of CA-Dental-Sacramento Health Plan of San Joaquin Health Plan of San Mateo 13 Managed Care Entity PACE Transportation PAHP Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Dental PAHP Dental PAHP Commercial MCO PACE Dental PAHP Commercial MCO Commercial MCO HIO Commercial MCO Dental PAHP HIO PACE Dental PAHP Dental PAHP PACE Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Dental PAHP Dental PAHP Commercial MCO *MCO/COHS Enrollment 19 45,645 15,360 1,665 2,173 2,834 844 4,773 3,117 12,019 3,250 19,107 6,658 9,741 137 3,559 1,241 2,396 3,983 911 1,886 2,039 3,972 492 411 2,207 7,880 67,165 154 733 15,153 358 361 196 64 2,206 2,129 724 491 7,188 1,097 211 1,461 14,945
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CO CO CO CO CO CO CO CO CO CO CO DC DC DC DC DC FL FL FL FL FL FL FL Inland Empire Health Plan Kern Family Health Care KP Cal, LLC KP Cal, LLC - Sacramento KP Cal, LLC-San Diego LA Care Health Plan Liberty Dental Plan of CA/Sacramento Liberty Dental Plan of CA-LA Molina Healthcare of California Partner Plan, Inc. - Sacramento Molina Healthcare of California Partner Plan, Inc. - San Diego Molina Healthcare of California Partner Plan, Inc.-TPMP On Lok Senior Health Services dba On Lok Lifeways Partnership Health Plan Positive Healthcare/AHF Healthcare Centers Safeguard Dental-LA San Francisco Health Plan Santa Barbara San luis Obispo Regional Health Authority Santa Clara Family Health Plan Senior Care Action Network (SCAN) Sutter Health sacramento Sierra dba Sutter Senior Care Western Dental Services-LA Western Dental Services-Sacramento Western Health Advantage Community Health Plan-Sacramento Access Behavioral Care Behavioral Healthcare, Inc. Colorado Health Partnerships Denver Health and Hospital Authority Foothills Behavioral Health Partners Northeast Behavioral Health Partnership Primary Care Physician Program Rocky Mountain Health Plan Authority Rocky Mountain PACE Total Long Term Care VOANS PACE, Inc DC Chartered Health Plan, Incorporated Health Right Incorporated Health Services For Children with Special Needs Medical Transportation Management Unison Health Plan of the Capital Area Access Health Solutions (Reform) Alzheimer's Waiver Service Provider American Eldercare Amerigroup Amerigroup (NHD) Amerigroup (Reform) Atlantic Dental, Inc. 14 Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Dental PAHP Dental PAHP Commercial MCO Commercial MCO Commercial MCO PACE HIO Medicaid-only MCO Dental PAHP Commercial MCO HIO Commercial MCO Medicaid-only MCO PACE Dental PAHP Dental PAHP Commercial MCO Mental Health (MH) PIHP Mental Health (MH) PIHP Mental Health (MH) PIHP Medicaid-only MCO Mental Health (MH) PIHP Mental Health (MH) PIHP PCCM Provider Medical-only PIHP PACE PACE PACE Medicaid-only MCO Medicaid-only MCO Medical-only PIHP Transportation PAHP Medicaid-only MCO Medical-only PIHP *Community Care for the Elderly Long Term Care PIHP Commercial MCO Long Term Care PIHP Commercial MCO Dental PAHP 5,699 1,771 362 1,840 1,139 10,856 949 328 595 903 665 958 16,835 250 1,654 1,457 14,807 5,491 6,920 196 2,315 2,706 910 9,155 9,421 19,627 2,788 6,906 6,285 4,786 1,884 23 1,215 118 173 42 17 11,048 36 467 294 3,821 4,765 2,301 121 94
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL GA Hi Better Health (Reform) Buena Vista Children's Medical Services (Reform) Citrus (NHD) Citrus Health Care First Coast Advantage (Reform) Florida PACE Centers Freedom Health Plan Freedom Health Plan (Reform) HealthEase HealthEase (Reform) Healthy Palm Beaches Hope Life Care Hope Select Care Humana Family Humana Family (Reform) Humana Medical Plan Humana Senior's Choice JMH Health Plan Little Havana Activities and Nutrition Centers Managed Care of North America Molina Health Care of Florida Molina Health Care of Florida (Reform) Neighborly Care Network NetPass (Reform) Preferred Medical Plan Preferred Medical Plan (Reform) Project Independence at Home South Florida Community Care Network (Reform) StayWell Sunshine State Health Plan Total Health Choice Total Health Choice (Reform) United Evercare United Health Care United Health Care (NHD) United Health Care (Reform) United Home Care Services Universal Health Care Universal Health Care (NHD) Universal Health Care (Reform) Urban Jacksonville Vista Health Plan of South Florida Vista Independence Plan YourCare Brevard Non-Emergency Transportation Brokerage Program Evercare 15 Medical-only PIHP Commercial MCO Medical-only PIHP Long Term Care PIHP Commercial MCO Medical-only PIHP PACE Commercial MCO Commercial MCO Medicaid-only MCO Commercial MCO Medicaid-only MCO Long Term Care PIHP PACE Commercial MCO Commercial MCO Long Term Care PIHP Long Term Care PIHP Commercial MCO Long Term Care PIHP Dental PAHP Medicaid-only MCO Commercial MCO Long Term Care PIHP Medical-only PIHP Commercial MCO Commercial MCO Long Term Care PIHP Medical-only PIHP Commercial MCO Medicaid-only MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Long Term Care PIHP Transportation PAHP Commercial MCO 25 469 12 1,226 488 570 221 24 9 3,724 78 2 203 98 1,584 172 605 303 571 847 1 234 32 522 251 416 31 105 329 3,725 150 70 199 1,940 2,092 2,198 29 918 285 682 86 96 372 1,233 62 129,559 12,450
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 HI HI IA IA ID ID KS KS KS KS KY KY LA MA MA MA MA MA MA MA MD MI MI MI MI MN MN MN MN MN MN MN MN MN MO MS NC NC NC NC NC ND NE NJ NJ NJ Maui PACE Ohana Iowa Plan For Behavioral Health Siouxland PACE Healthy Connections Medicare-Medicaid Coordinated Plan Kansas Health Solutions Midland Care Services ValueOptions-Kansas Via Christi Healthcare Outreach Programs for Elders Human Service Transportation Passport Health Plan Greater New Orleans Elder Service Plan of Cambridge Health Alliance Elder Service Plan of East Boston Elder Service Plan of Harbor Health Services, Inc. Elder Service Plan of the North Shore, Inc. Neighborhood Health Plan Summit Elder Care Uphams Elder Service Plan Hopkins Elder Plus Care Resources Comprehensive Senior Care Corporation Henry Ford Health System-Center for Senior Independence Life Circles Blue Plus First Plan Blue Health Partners Itasca Medical Care Medica Metropolitan Health Plan PrimeWest Health System South Country Health Alliance UCARE Alexian Brothers Community Services LogistiCare Soultions, LLC Carolina Access Community Care of North Carolina (Access II/III) Piedmont Cardinal Health Plan Piedmont Senior Care Elderhaus Northland PACE Magellan Behavioral Health AmeriChoice of New Jersey, Inc. AMERIGROUP New Jersey, Inc. Health Net of New Jersey, Inc. 16 PACE Commercial MCO MH/SUD PIHP PACE PCCM Provider Medical-only PAHP Mental Health (MH) PAHP PACE Substance Use Disorders (SUD) PIHP PACE Transportation PAHP Medicaid-only MCO PACE PACE PACE PACE PACE Commercial MCO PACE PACE PACE PACE PACE PACE PACE Commercial MCO Commercial MCO Commercial MCO Medicaid-only MCO Commercial MCO Commercial MCO Medicaid-only MCO Medicaid-only MCO Commercial MCO PACE Transportation PAHP PCCM Provider PCCM Provider MH/SUD PIHP PACE PACE PACE *Specialty Physician Case Commercial MCO Medicaid-only MCO Medicaid-only MCO 13 12,863 32,222 3 15,822 1,030 33,252 53 33,252 172 88,914 12,557 97 178 277 284 595 153 578 135 129 146 14 189 21 12,801 1,450 3,845 614 12,266 1,371 3,319 3,544 10,343 152 69,166 6,623 40,334 13,241 4 24 20 19,557 5,853 2,184 1,490
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 NJ NJ NJ NJ NM NM NM NV NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY OH OH OK Horizon NJ Health LIFE St. Francis LIFE at Lourdes University Health Plans, Inc. AMERIGROUP Community Care of New Mexico, Inc. Evercare of New Mexico Total Community Care (PACE) Logisticare Affinity/Medicaid Advantage Amerigroup Community Connections Broome County MC CCM Select Comprehensive Care Management (CCM) Eddy Senior Care GHI/Medicaid Advantage Guildnet GuildNet/Medicaid Advantage Plus Health Advantage/Elant Choice Health Now/Medicaid Advantage HHH Choices HIP Health Plan/Medicaid Advantage HomeFirst Independent Care Systems Independent Living For Seniors Liberty Health Advantage/Medicaid Advantage Managed Health Inc/Medicaid Advantage MetroPlus/Medicaid Advantage Neighborhood Health Provider/Medicaid Advantage NYS Catholic Health Plan/Fidelis/Medicaid Advantage PACE CNY Partners In Community Care Physician Case Management Program Senior Health Partners Senior Network Health Senior Whole Health Medicaid Advantage Plus Senior Whole Health/ Medicaid Advantage Southern Tier Priority Total Aging in Place Total Senior Care Touchstone/Prestige/Medicaid Advantage VNS Choice VNS Choice Plus/Medicaid Advantage Plus WellCare Advantage Plus/Medicaid Advantage Plus WellCare Advocate Concordia Care TriHealth Senior Link Cherokee Elder Care 17 Medicaid-only MCO PACE PACE Commercial MCO Commercial MCO Commercial MCO PACE Transportation PAHP Commercial MCO Long Term Care PIHP PCCM Provider Long Term Care PIHP PACE PACE Commercial MCO Long Term Care PIHP Long Term Care PIHP Long Term Care PIHP Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Long Term Care PIHP PACE Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO PACE Long Term Care PIHP PCCM Provider Long Term Care PIHP Long Term Care PIHP Long Term Care PIHP Commercial MCO PCCM Provider Long Term Care PIHP PACE Commercial MCO Long Term Care PIHP Long Term Care PIHP Long Term Care PIHP Long Term Care PIHP PACE PACE PACE 9,394 14 14 1,350 16,250 15,095 355 38,060 81 355 11 1,017 1,986 97 904 5,402 160 129 165 617 1,949 2,975 722 219 610 51 8 193 229 309 245 1,000 1,371 355 135 593 8 135 15 508 6,904 21 123 251 204 375 46
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 OK OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR PA PA PA PA PA PA PA PA PA SoonerRide Accountable Behavioral Health Capitol Dental Care Inc. Care Oregon Cascade Comprehensive Care Central Oregon Independent Health Solutions Clackamas County Mental Health Deschutes County CDO Doctors of the Oregon Coast South Douglas County IPA FamilyCare (Mental Health) FamilyCare Health Plans Greater Oregon Behavioral Health, Inc. Hayden Family Dentistry Inter-Community Health Network Jefferson Behavioral Health Kaiser Permanente Oregon Plus Lane Care MHO Lane Individual Practice Association Managed Dental Care of Oregon Marion Polk Community Health Plan Mid Valley Behavioral Care Network Mid-Rogue Independent Practice Assoc. Multicare Dental Multnomah County Verity Northwest Dental Services ODS Community Health Inc. Oregon Dental Service Oregon Health Management Service PCCM Providence Elder Place Providence Health Assurance Tuality Health Care Washington County Health (Mental Health) Willamette Dental Access Plus Program Albright LIFE AmeriChoice of Pennsylvania AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan - VOL Community Care Behavioral Health - North Central Community Care Behavioral Health - Northeast Community LIFE Counties of Armstrong/Indiana - Value Behavioral Health of PA Transportation PAHP Mental Health (MH) PIHP Dental PAHP Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Mental Health (MH) PIHP Substance Use Disorder (SUD) PAHP Medicaid-only MCO Commercial MCO Mental Health (MH) PIHP Commercial MCO Mental Health (MH) PIHP Dental PAHP Medicaid-only MCO Mental Health (MH) PIHP Medicaid-only MCO Mental Health (MH) PIHP Medicaid-only MCO Dental PAHP Medicaid-only MCO Mental Health (MH) PIHP Medicaid-only MCO Dental PAHP Mental Health (MH) PIHP Dental PAHP Medicaid-only MCO Dental PAHP Medicaid-only MCO PCCM Provider PACE Medicaid-only MCO Medicaid-only MCO Mental Health (MH) PIHP Dental PAHP PCCM Provider Medical-only PIHP Commercial MCO Commercial MCO Commercial MCO MH/SUD PIHP MH/SUD PIHP PACE MH/SUD PIHP 98,219 3,427 13,921 10,229 690 911 3,959 2,300 1,113 1,333 995 1,861 6,206 5,305 1,893 7,494 706 5,464 2,945 968 3,958 8,979 1,346 2,438 11,313 6,498 300 10,064 433 905 555 2,040 811 4,507 7,462 626 44 271 255 5 18,939 11,562 283 2,863
18
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 Counties of Bedford/Somerset - Community Behavioral Healthcare Network of Pennsylvania MH/SUD PIHP Counties of Carbon/Monroe/Pike - Community Care Behavioral Health MH/SUD PIHP Counties of Crawford/Mercer/Venango - Value Behavioral Health Counties of Franklin/Fulton - Community Behavorial Healthcare Network of Pennsylvania Counties of Lycoming/Clinton - Community Behavioral Healthcare Network of Pennsylvania County of Adams - Community Care Behavioral Health County of Allegheny - Community Care Behavioral Health County of Beaver - Value Behavioral Health of PA County of Berks - Community Care Behavioral Health County of Blair County - Community Behavioral Healthcare Network of PA County of Bucks - Magellan Behavioral Health County of Butler - Value Behavioral Health of PA County of Cambria - Value Behavioral Health County of Chester - Community Care Behavioral Health County of Cumberland - Community Behavioral Healthcare Network of PA, Inc. County of Dauphin - Community Behavioral Healthcare Network of PA, Inc. County of Delaware - Magellan Behavioral Health County of Erie - Value Behavioral Health County of Fayette - Value Behavioral Health of PA County of Lancaster - Community Behavioral Healthcare Network of PA, Inc. County of Lawrence - Value Behavioral Health of PA County of Lebanon - Community Behavioral Healthcare Network of PA, Inc. County of Lehigh - Magellan Behavioral Health County of Montgomery - Magellan Behavioral Health County of Northampton - Magellan Behavioral Health County of Perry - Community Behavioral Healthcare Network of PA, Inc. County of Philadelphia - Community Behavioral Health County of Washington - Value Behavioral Health of PA County of Westmoreland - Value Behavioral Health of PA County of York - Community Care Behavioral Health Everyday LIFE Gateway Health Plan, Inc. Gateway Health Plan, Inc. -VOL Health Partners of Philadelphia Keystone Mercy Health Plan LIFE - Beaver County 19 MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP PACE Commercial MCO Commercial MCO Commercial MCO Commercial MCO PACE
PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA
2,275 3,401 5,378 1,838 2,752 849 19,370 2,841 5,020 2,654 5,074 1,991 2,756 2,999 1,711 3,470 6,516 4,506 3,776 5,288 1,819 1,485 4,965 5,900 3,333 456 38,630 3,081 5,387 4,265 4 504 42 351 526 114
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PR PR PR PR PR PR PR PR PR PR PR PR RI SC SC SC SC TN TN TN TN TN TN TN TN TN TN TN TX TX LIFE - Geisinger LIFE - Pittsburgh LIFE - University of Pennsylvania LIFE at Home LIFE Butler County LIFE Lutheran Services LIFE NWPA Logisticare Solutions, LLC McKesson Health Solutions Mercy LIFE New Courtland LIFE Senior LIFE Johnstown Unison Health Plan / MedPLUS Unison Health Plan/MedPlus - VOL UPMC Health Plan, Inc./UPMC for You UPMC Health Plan, Inc./UPMC for You - VOL Value Behavioral Health of PA (Greene County) American Health Medicare APS Healthcare FHC Healthcare Humana Health Plans of Puerto Rico, Inc. Humana Puerto Rico MCS Advantage MCS Health Management Options, Inc. MMM Healthcare Inc. PMC Medicare Choice Salud Dorada con Medicare Triple S Triple-S, Inc. PACE Organization of Rhode Island Logisticare Palmetto SeniorCare (PACE) South Carolina Solutions The Oaks PACE Alexian Brothers Community Services AmeriChoice - East TN AmeriChoice - Middle TN AmeriChoice - West TN AmeriGroup Community Care Doral Dental of Tennessee, LLC Premier Behavioral Systems of TN SXC Health Solution Corperation Volunteer State Health Plan (Bluecare) - East Volunteer State Health Plan (Bluecare) - West Volunteer State Health Plan (TennCare Select) Amerigroup (STAR+PLUS) Bienvivir Senior Health Service 20 PACE PACE PACE PACE Medical-only PIHP PACE Medical-only PIHP Transportation PAHP Disease Management PAHP PACE Medical-only PIHP PACE Commercial MCO Commercial MCO Commercial MCO Commercial MCO MH/SUD PIHP Commercial MCO MH/SUD PIHP MH/SUD PIHP Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO PACE Transportation PAHP PACE PCCM Provider PACE PACE Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Medicaid-only MCO Dental Benefit Manager MH/SUD PIHP Pharmacy Benefit Manager Medicaid-only MCO Medicaid-only MCO *PIHP Medicaid-only MCO PACE 96 303 314 51 15 14 27 50,942 13 221 100 140 280 63 277 7 856 14,134 22,054 11,444 14,065 8,338 40,124 16,382 48,755 32,093 3,292 18,405 20,829 153 128,711 367 8,337 28 309 34,401 27,960 24,883 28,086 347 5,528 192,774 45,569 26,347 5,528 27,021 700
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 TX TX TX TX TX UT UT UT UT UT UT UT UT UT UT UT UT UT VA VA VA VA VA VT VT WA WA WA WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI Evercare Jan Werner Adult Day Care Center Molina (STAR+Plus) Superior HealthPlan (STAR+Plus) ValueOptions Bear River Mental Health Central Utah Counseling Center Davis Behavioral Health Four Corners Community Behavioral Health Healthy U Molina Healthcare of Utah (Molina) Non-Emergency Medical Transportation Northeastern Counseling Center Select Access Southwest Behavioral Health Services Valley Mental Health Wasatch Mental Health Weber Human Services AllCare for Seniors LogistiCare Solutions Mountain Empire Riverside Peninsula Sentara Senior Community Care Global Committment to Health Vermont PACE Molina Healthcare (WMIP) Providence ElderPlace - Seattle Regional Support Network Abri Health Plan -- Medicaid HMO Abri Health Plan -- SSI Care Wisconsin First, Inc. Care Wisconsin Health Plan, Inc. (Partnership) Children's Community Health Plan - Medicaid HMO CHP-LTS, Inc. Community Care Health Plan, Inc. Community Care, Inc. Community Care of Central Wisconsin Community Care Organization (PACE) Community Health Partnership -- Partnership Compcare (formerly Atrium Health Plan) -- Medicaid HMO Dean Health Plan -- Medicaid HMO Family Care Group Health Cooperative Of Eau Claire -- Medicaid HMO Group Health Cooperative of Eau Claire County SSI Group Health Cooperative Of South Central WI -- Medicaid HMO Gundersen Lutheran Health Plan - Medicaid HMO 21 Medicaid-only MCO PACE Medicaid-only MCO Medicaid-only MCO MH/SUD PIHP Mental Health (MH) PIHP Mental Health (MH) PIHP Mental Health (MH) PIHP Mental Health (MH) PIHP Medical-only PIHP Medical-only PIHP Transportation PAHP Mental Health (MH) PIHP PCCM Provider Mental Health (MH) PIHP Mental Health (MH) PIHP Mental Health (MH) PIHP Mental Health (MH) PIHP PACE Transportation PAHP PACE PACE PACE Medicaid-only MCO PACE Commercial MCO PACE Mental Health (MH) PIHP Commercial MCO Commercial MCO Long Term Care PIHP Medicaid-only MCO Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Long Term Care PIHP PACE Commercial MCO Commercial MCO Commercial MCO Long Term Care PIHP Commercial MCO Commercial MCO Commercial MCO Commercial MCO 32,312 126 10,087 16,934 1,017 715 631 1,106 488 2,855 2,797 14,534 366 4,621 1,205 6,825 1,938 1,863 26 106,372 45 104 121 14,832 72 519 304 97,637 8 373 2,243 977 1 704 1,006 2,916 2,434 499 247 18 6 16,912 13 101 1 5
DUAL ELIGIBLE ENROLLMENT BY PLAN AS OF 6/30/2009 WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI Total Health Tradition Health Plan -- Medicaid HMO Independent Care (iCare) - Medicaid HMO Independent Care Health Plan -- SSI Lakeland Care District Managed Health Services -- Medicaid HMO Managed Health Services -- SSI MercyCare Insurance Company -- Medicaid HMO Milwaukee County Dept. on Aging Network Health Plan -- Medicaid HMO Network Health Plan - SSI Northern Bridges Partnership Health Plan Inc. Security Health Plan -- Medicaid HMO Southern Family Care Alliance UnitedHealthcare of WI -- Medicaid HMO UnitedHealthcare of WI -- SSI Unity Health Insurance -- Medicaid HMO Western Wisconsin Cares Commercial MCO Medicaid-only MCO Medicaid-only MCO Long Term Care PIHP Medicaid-only MCO Medicaid-only MCO Commercial MCO Long Term Care PIHP Commercial MCO Commercial MCO Long Term Care PIHP Commercial MCO Commercial MCO Long Term Care PIHP Commercial MCO Commercial MCO Commercial MCO Long Term Care PIHP 5 9 3,077 863 31 928 8 6,295 40 403 739 1,667 27 771 111 880 16 2,439 2,809,037
22
Medicaid Managed Care Program Summary

June 30, 2009 Managed Care Entity
Medical-only PIHP Medical-only PIHP PCCM PCCM Transp PAHP PACE
State
AL AL AL AR AR AR
Plan
Maternity Care Program Partnership Hospital Program Patient 1st Connect Care Non-Emergency Transportation Total Life Healthcare
Reimbursement Arrangement
Risk-based Capitation Risk-based Capitation Fee-For-Service Fee-For-Service Risk-based Capitation Risk-based Capitation
Operating Authority
1915(b) 1915(a) 1902(a)(4) 1915(b) 1115 1915(b) PACE
Geographic Area Served

Statewide Statewide Statewide Statewide Statewide 72315, 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, 72476 La Paz, Maricopa, Pima, Yuma LaPaz, Maricopa, Pima, Yuma Yavapai LaPaz, Maricopa, Yuma Yavapai Maricopa Maricopa Cochise, Graham, Greenlee Statewide
Number of Enrollees
21,324 518,769 443,327 411,351 451,863 21
AZ AZ AZ AZ AZ AZ AZ AZ AZ
AZ Physicians IPA (Family Planning Extension) AZ Physicians IPA (HP) Bridgeway (Family Planning Extension) Bridgeway Health Solution (HP) Bridgeway Health Solution (PC) Care 1st Health Plan Care 1st Health Plan (Family Planning Extension) Cochise Co. Dept. of Health Services (PC) Department of Economic Security/Childrens Medical and Dental Program (Family Planning Extension)
Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115 1115 1115 1115 1115 1115 1115 1115 1115
604 220,485 56 16,182 2,405 49,355 208 938 0
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
Page 23

Medicaid MCO
State
AZ
Plan
Department of Economic Security/Childrens Medical and Dental Program (HP) Department of Economic Security/Division of Developmental Disabilities (PC) Department of Health Services (Behavioral Health) Evercare Select (PC) Health Choice Arizona (Family Planning Extension) Health Choice Arizona (HP) Maricopa County Health Plan (Family Planning Extension) Maricopa County Health Plan (HP) Mercy Care Plan (Family Planning Extension) Mercy Care Plan (HP) Mercy Care Plan (PC) Phoenix Health Plan/Community Connection (Family Planning Extension) Phoenix Health Plan/Community Connection (HP) Pima Health System (Family Planning Extension) Pima Health System (HP)
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1115

Statewide
Number of Enrollees
9,533
AZ
Medicaid MCO
1115
Statewide
21,753
AZ
MH/SUD PIHP
1115
Apache, Cochise, Coconino, Gila, Graham, Greenlee, LaPaz, Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz, Yavapai, Yuma Apache, Coconino, La Paz, Maricopa, Mohave, Navajo, Yuma Apache, Coconino, LaPaz, Maricopa, Mohave, Navajo, Pima, Santa Cruz, Yuma Apache, Coconino, LaPaz, Maricopa, Mohave, Navajo, Pima, Santa Cruz, Yuma Maricopa Maricopa Cochise, Graham, Greenlee, Maricopa, Pima Cochise, Graham, Greenlee, Maricopa, Pima Maricopa Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pima, Pinal, Yavapai Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pima, Pinal, Yavapai Pima Pima
104,101
AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ
Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO
1115 1115 1115 1115 1115 1115 1115 1115 1115 1115 1115 1115
3,647 791 177,142 109 51,234 994 283,456 8,388 710 174,038 12 2,153
Page 24

Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Dental PAHP Dental PAHP Commercial MCO PACE Dental PAHP Commercial MCO Commercial MCO HIO Commercial MCO Dental PAHP
State
AZ AZ AZ AZ AZ AZ CA CA CA CA CA CA CA CA CA CA
Plan
Pima Health System (PC) Pinal County Long Term Care (PC) SCAN University Family Care (Family Planning Extension) University Family Care (HP) Yavapai County Long Term Care (PC) Access Dental Plan-LA Access Dental Plan-Sacramento Alameda Alliance for Health AltaMed Health Services Corporation American Health Guard-Dental Plan-LA Anthem Blue Cross Partnership Plan Sacramento Anthem Blue Cross Partnership PlanTPMP Caloptima-Orange Care 1st Health Plan/San Diego Care 1st Health Plan-Dental-LA
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1115 1115 1115 1115 1115 1115 1915(a) 1915(a) 1915(b), 1932(a) PACE 1915(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b) 1915(b), 1932(a) 1915(a)

Pima, Santa Cruz Gila, Pinal Maricopa Cochise, Gila, Graham, Greenlee, Pima, Pinal, Santa Cruz Cochise, Gila, Graham, Greenlee, Pima, Pinal, Santa Cruz Yavapai Los Angeles Sacramento Alameda LA Los Angeles Sacramento Alameda, Contra Costa, Fresno, San Francisco, San Joaquin, Santa Calra, Stanislaus, Tulare Orange San Diego Los Angeles
Number of Enrollees
4,210 1,433 2,591 159 62,763 1,016 104,353 51,946 88,767 622 16,938 86,166 349,162 327,163 9,126 17,632
Page 25

HIO PACE Dental PAHP Dental PAHP PACE Commercial MCO Commercial MCO Commercial MCO Commercial MCO Commercial MCO Dental PAHP Dental PAHP Commercial MCO *MCO/COHS Commercial MCO Commercial MCO
State
CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA
Plan
Central Coast Alliance For Health Coalition of Elders Independence dba Center for Elders Independence Community Dental Services/Sacramento Community Dental Services-LA Community Eldercare of San Diego dba St. Paul's PACE Community Health Group Partnership Plan-San Diego Contra Costa Health Plan Health Net Community Solutions, Inc. Sacramento Health Net Community Solutions, Inc.San Diego Health Net Community Solutions, Inc.TPMP Health Net of CA-Dental-LA Health Net of CA-Dental-Sacramento Health Plan of San Joaquin Health Plan of San Mateo Inland Empire Health Plan Kern Family Health Care
Operating Authority
1915(b) PACE 1915(b), 1932(a) 1915(a) PACE 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(a) 1915(a) 1915(b), 1932(a) 1915(b) 1915(b), 1932(a) 1915(b), 1932(a)

Monterey, Santa Cruz Alameda Sacramento Los Angeles San Diego San Diego Contra Costa Sacramento San Diego Fresno, Kern, LA, Stanislaus, Tulare Los Angeles Sacramento San Joaquin San Mateo Riverside, San Bernardino Kern
Number of Enrollees
96,468 413 12,805 4,889 77 86,241 53,869 34,498 30,586 582,166 31,247 12,078 67,793 52,908 344,595 100,487
Page 26

Commercial MCO Commercial MCO Commercial MCO Commercial MCO Dental PAHP Dental PAHP Commercial MCO Commercial MCO Commercial MCO PACE HIO Medicaid MCO Dental PAHP *Emotional and Mental Health Support PIHP Commercial MCO HIO
State
CA CA CA CA CA CA CA CA CA CA CA CA CA CA
Plan
KP Cal, LLC KP Cal, LLC - Sacramento KP Cal, LLC-San Diego LA Care Health Plan Liberty Dental Plan of CA/Sacramento Liberty Dental Plan of CA-LA Molina Healthcare of California Partner Plan, Inc. - Sacramento Molina Healthcare of California Partner Plan, Inc. - San Diego Molina Healthcare of California Partner Plan, Inc.-TPMP On Lok Senior Health Services dba On Lok Lifeways Partnership Health Plan Positive Healthcare/AHF Healthcare Centers Safeguard Dental-LA San Francisco City & CO/Family Mosaic
Operating Authority
1915(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b), 1932(a) PACE 1915(b) 1915(a) 1915(a) 1915(a)

Marin, Sonoma Sacramento San Diego Los Angeles Sacramento LA Sacramento San Diego Riverside, San Bernardino San Francisco Napa, Solano, Yolo Los Angeles Los Angeles, Riverside, San Bernardino San Francisco
Number of Enrollees
2,328 24,405 13,085 763,736 27,192 7,095 22,791 53,645 89,952 995 94,280 587 21,801 157
CA CA
San Francisco Health Plan Santa Barbara San luis Obispo Regional Health Authority
1915(b), 1932(a) 1915(b)
San Francisco Santa Barbara
34,567 83,751
Page 27

Commercial MCO Medicaid MCO PACE Dental PAHP Dental PAHP Commercial MCO Mental Health PIHP Mental Health PIHP Medicaid MCO Mental Health PIHP
State
CA CA CA CA CA CA CO CO CO CO
Plan
Santa Clara Family Health Plan Senior Care Action Network (SCAN) Sutter Health sacramento Sierra dba Sutter Senior Care Western Dental Services-LA Western Dental Services-Sacramento Western Health Advantage Community Health Plan-Sacramento Access Behavioral Care Behavioral Healthcare, Inc. Colorado Access Colorado Health Partnerships
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1915(b), 1932(a) 1915(a) PACE 1915(a) 1915(b), 1932(a) 1915(b), 1932(a) 1915(b) 1915(b) 1915(a) 1915(b)

Santa Clara LA, Riverside, San Barnardino Sacramento, Yolo Los Angeles, Riverside, Sacramento, San Bernardino Sacramento Sacramento Denver East Metro Denver Adams, Arapahoe, Boulder, Broomfield, Denver Alamosa, Archuleta, Baca, Bent, Chaffee, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, El Paso, Fremont, Garfield, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, La Plata, Lake, Las Animas, Mesa, Mineral, Moffat, Montezuma, Montrose, Otero, Ouray, Park, Pitkin, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, San Miguel, Summit, Teller Adams, Arapahoe, Denver, Jefferson Boulder, Broomfield, Clear Creek, Gilpin, Jefferson Cheyenne, Elbert, Kit Carson, Larimer, Lincoln, Logan, Morgan, Phillips, Sedgwick, Washington, Weld, Yuma Statewide Delta, Mesa, Montrose, Ouray, Rio Blanco, San Miguel
Number of Enrollees
89,930 6,920 204 55,845 83,840 16,070 80,507 103,730 2,315 157,160
CO CO CO CO CO
Denver Health and Hospital Authority Foothills Behavioral Health Partners Northeast Behavioral Health Partnership Primary Care Physician Program Rocky Mountain Health Plan Authority
Medicaid MCO Mental Health PIHP Mental Health PIHP PCCM Medical-only PIHP
Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Non-risk Capitation
1915(a) 1915(b) 1915(b) 1932(a) 1915(a)
41,932 50,500 56,410 22,426 15,157
Page 28

PACE PACE PACE Commercial MCO Medicaid MCO Medicaid MCO PCCM Medicaid MCO Medicaid MCO Medical-only PIHP Transp PAHP Medicaid MCO Medicaid MCO *Fee for Service Model Medicaid MCO Medical-only PAHP
State
CO CO CO CT CT CT CT DC DC DC DC DC DE DE DE FL
Plan
Rocky Mountain PACE Total Long Term Care VOANS PACE, Inc Aetna Better Health Americhoice by United HealthCare Community Health Network of Connecticut HUSKY Primary Care DC Chartered Health Plan, Incorporated Health Right Incorporated Health Services For Children with Special Needs Medical Transportation Management Unison Health Plan of the Capital Area Delaware Physicians Care, Inc Diamond State Partners Unison Health Plan of Delaware, Inc. Access Health Solutions
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Non-risk Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Non-risk Capitation
Operating Authority
PACE PACE PACE 1915(b) 1915(b) 1915(b) 1915(b) 1932(a) 1932(a) 1915(a) 1902(a)(70) 1932(a) 1115 1115 1115 1915(b)

El Paso Adams, Arapahoe, Denver, Jefferson Delta, Montrose Statewide Statewide Statewide Greater Waterbury, Greater Windham Statewide Statewide Statewide Statewide Statewide Statewide Statewide Statewide Baker, Brevard, Broward, Clay, Duval, Flagler, Hardee, Indian River, Manatee, Martin, Nassau, Okeechobee, Orange, Osceola, Palm Beach, Polk, Seminole, St. Johns, St. Lucie, Volusia
Number of Enrollees
37 1,263 121 83,069 39,163 220,384 168 63,915 20,356 3,593 50,174 12,368 78,603 8,487 38,999 57,539
Page 29

Medical-only PIHP *Adult Day Health Care Facility Disease Management PAHP Disease Management PAHP *Community Care for the Elderly Agencies Long Term Care PIHP
State
FL FL
Plan
Access Health Solutions (Reform) Adult Day Health Care
FFS/Some Risk Capitation Fee-For-Service
Operating Authority
1115 1915(b)/(c)

Baker, Broward, Clay, Duval, Nassau Lee, Palm Beach
Number of Enrollees
51,260 37
FL
AIDS Healthcare Foundation, Inc.
Non-risk Capitation Non-risk Capitation Fee-For-Service
1915(b)
Statewide
6,015
FL
Alternative Medicine Integration
1915(b)
Hillsborough, Pasco, Pinellas
428
FL
Alzheimer's Waiver Service Provider
1915(b)/(c)
Broward, Dade, Palm Beach, Pinellas
310
FL
American Eldercare
Risk-based Capitation
1915(a)/(c)
Alachua, Brevard, Broward, Charlotte, Clay, Dade, Duval, Flagler, Hernando, Highlands, Hillsborough, Indian River, Lake, Lee, Manatee, Marion, Martin, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Johns, St. Lucie, Volusia Brevard, Broward, Dade, Hernando, Hillsborough, Lake, Lee, Manatee, Orange, Osceola, Pasco, Pinellas, Polk, Sarasota, Seminole, Volusia Brevard, Broward, Charlotte, Citrus, Collier, Dade, Duval, Hernando, Hillsborough, Indian River, Lake, Lee, Manatee, Marion, Martin, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Johns, St. Lucie, Volusia Broward Dade Broward County Broward, Dade, Gadsden, Hendry, Jefferson, Leon, Liberty, Madison, Wakulla Statewide
3,821
FL
Amerigroup
Commercial MCO
Risk-based Capitation Risk-based Capitation
1915(b)
155,880
FL
Amerigroup (NHD)
Long Term Care PIHP
1915(a)/(c)
2,301
FL FL FL FL FL
Amerigroup (Reform) Atlantic Dental, Inc. Better Health (Reform) Buena Vista Caremark
Commercial MCO Dental PAHP Medical-only PIHP Commercial MCO Disease Management PAHP
Risk-based Capitation Risk-based Capitation FFS w/Some Risk Capitation Risk-based Capitation Non-risk Capitation
1115 1915(b) 1115 1915(b) 1915(b)
22,262 175,971 4,410 20,981 85
Page 30

Medical-only PIHP Long Term Care PIHP
State
FL FL
Plan
Children's Medical Services (Reform) Citrus (NHD)
FFS/Some Risk Capitation Risk-based Capitation
Operating Authority
1115 1915(a)/(c)

Broward, Duval Alachua, Brevard, Broward, Citrus, Dade, Duval, Hernando, Hillsborough, Lake, Manatee, Marion, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, Volusia Hillsborough, Lake, Orange, Osceola, Pasco, Pinellas, Polk, Seminole Statewide Duval Hillsborough, Lee, Osceola, Pasco 33125, 33127, 33128, 33129, 33130, 33131, 33132, 33135, 33136, 33137, 33138, 33139, 33140, 33141, 33142, 33147, 33150, 33154, 33161, 33167, 33168, 33181 Dade, Palm Beach Broward Brevard, Broward, Calhoun, Citrus, Dade, Duval, Escambia, Gadsden, Highlands, Hillsborough, Jefferson, Lake, Leon, Liberty, Madison, Manatee, Marion, Martin, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, Santa Rosa, Sarasota, Seminole, Volusia, Wakulla Duval Statewide
Number of Enrollees
5,484 1,226
FL FL FL FL FL
Citrus Health Care Commission for the Transportation of the Disadvantaged First Coast Advantage (Reform) Florida Health Partners, Inc. Florida PACE Centers
Commercial MCO Transp PAHP Medical-only PIHP Mental Health PIHP PACE
Risk-based Capitation Flat Rate per Ride FFS/Some Risk Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1915(b) 1915(b) 1115 1915(b) PACE
27,039 70,965 29,032 188,934 231
FL FL FL
Freedom Health Plan Freedom Health Plan (Reform) HealthEase
Commercial MCO Commercial MCO Medicaid MCO
1915(b) 1115 1915(b)
2,191 1,022 179,142
FL FL
HealthEase (Reform) HealthierFlorida (Pfizer Health Solutions, Inc.) Healthy Palm Beaches Hemophilia of the Sunshine State
Commercial MCO Disease Management PAHP Medicaid MCO Disease Management PAHP
Risk-based Capitation Non-risk Capitation Risk-based Capitation Non-risk Capitation
1115 1915(b)
23,508 10,171
FL FL
1915(b) 1915(b)
Palm Beach Statewide
7,833 130
Page 31

Long Term Care PIHP PACE Commercial MCO Commercial MCO Long Term Care PIHP Long Term Care PIHP Commercial MCO Mental Health PIHP Long Term Care PIHP Mental Health PIHP Dental PAHP PCCM Medicaid MCO Commercial MCO Long Term Care PIHP
State
FL FL FL FL FL
Plan
Hope Life Care Hope Select Care Humana Family Humana Family (Reform) Humana Medical Plan
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1915(a)/(c) PACE 1915(b) 1115 1915(a)/(c)

Charlotte, Collier, Hendry, Lee Lee Broward, Dade, Palm Beach Broward Broward, Dade, Duval, Flagler, Hillsborough, Manatee, Nassau, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Johns, Volusia Brevard, Broward, Dade, Indian River, Martin, Okeechobee, Palm Beach, St. Lucie Dade Escambia Broward, Dade, Palm Beach Dade, Leon, Palm Beach, Volusia Dade Statewide Broward (Reform), Dade, Hillsborough, Palm Beach, Pasco, Pinellas, Polk Broward County Brevard, Broward, Citrus, Dade, Hernando, Hillsborough, Indian River, Manatee, Martin, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Lucie
Number of Enrollees
203 98 36,703 15,063 605
FL FL FL FL FL FL FL FL FL FL
Humana Senior's Choice JMH Health Plan Lakeview Center, Inc. Little Havana Activities and Nutrition Centers Magellan Behavioral Health of Florida Managed Care of North America MediPass Molina Health Care of Florida Molina Health Care of Florida (Reform) Neighborly Care Network
1915(a)/(c) 1915(b) 1915(b) 1915(a)/(c) 1915(b) 1915(b) 1915(b) 1915(b) 1115 1915(a)/(c)
303 15,200 31,116 847 213,091 6,228 455,877 23,731 5,023 522
Page 32

Medical-only PAHP
State
FL
Plan
NetPass
Operating Authority
1915(b)

Baker, Brevard, Broward, Clay, Duval, Flagler, Hardee, Indian River, Manatee, Martin, Nassau, Okeechobee, Orange, Osceola, Palm Beach, Polk, Seminole, St. Johns, St. Lucia, Volusia Broward Alachua Broward, Dade Broward Dade, Hillsborough, Lee, Pinellas Dade Dade Dade Broward Brevard, Broward, Dade, Hernando, Hillsborough, Lee, Manatee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Lucie, Sumter Dade, Hillbourough, Pasco, Pinellas Broward, Dade Broward Broward, Dade
Number of Enrollees
13,568
FL FL FL FL FL FL FL FL FL FL
NetPass (Reform) North Florida Behavioral Health Partnership Preferred Medical Plan Preferred Medical Plan (Reform) Prestige Health Choice Project Independence at Home Provider Service Network Public Health Trust of Dade County South Florida Community Care Network (Reform) StayWell
Medical-only PIHP Mental Health PIHP Commercial MCO Commercial MCO Medicaid MCO Long Term Care PIHP *Shared Savings Model Mental Health PIHP Medical-only PIHP Commercial MCO
FFS/Some Risk Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation FFS/Some Risk Capitation Risk-based Capitation FFS/Some Risk Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115 1915(b) 1915(b) 1115 1915(b) 1915(a)/(c) 1915(b) 1915(b) 1115 1915(b)
8,002 88,856 14,512 2,735 16,327 105 9,045 47,332 17,792 178,605
FL FL FL FL
Sunshine State Health Plan Total Health Choice Total Health Choice (Reform) United Evercare
Medicaid MCO Commercial MCO Commercial MCO Commercial MCO
1915(b) 1915(b) 1115 1915(b)
22,298 2,753 18,819 2,126
Page 33

Commercial MCO
State
FL
Plan
United Health Care
Operating Authority
1915(b)

Brevard, Broward, Citrus, Dade, Duval, Hernando, Highlands, Hillsborough, Lake, Manatee, Marion, Osceola, Palm Beach, Pasco, Pinellas, Polk, Seminole, Volusia Brevard, Broward, Charlotte, Citrus, Dade, Duval, Hernando, Hillsborough, Lake, Lee, Manatee, Marion, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Johns, Volusia Baker, Clay, Duval, Nassau Dade Dade, Gadsden, Hernando, Hillsborough, Jefferson, Leon, Manatee, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Wakulla Brevard, Charlotte, Citrus, Clay, Collier, Dade, Hernando, Hillsborough, Lake, Lee, Manatee, Marion, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole Broward, Duval Clay, Duval, St. Johns Dade Broward, Dade, Palm Beach Brevard Atlanta Region, East Region, North Region, Southeast Region Statewide Statewide Atlanta Region, Central Region, Southwest Region
Number of Enrollees
80,591
FL
United Health Care (NHD)
Long Term Care PIHP
1915(a)/(c)
2,198
FL FL FL
United Health Care (Reform) United Home Care Services Universal Health Care
Commercial MCO Long Term Care PIHP Commercial MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation
1115 1915(a)/(c) 1915(b)
10,815 918 23,127
FL
Universal Health Care (NHD)
Long Term Care PIHP Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP Long Term Care PIHP Medicaid MCO PCCM Transp PAHP Medicaid MCO
1915(a)/(c)
682
FL FL FL FL FL GA GA GA GA
Universal Health Care (Reform) Urban Jacksonville Vista Health Plan of South Florida Vista Independence Plan YourCare Brevard Amerigroup Community Care Georgia Better Health Care Non-Emergency Transportation Brokerage Program Peach State Health Plan
1115 1915(a)/(c) 1915(b) 1915(a)/(c) 1915(a)/(c) 1932(a) 1932(a) 1902(a)(70) 1932(a)
7,003 96 18,945 1,233 62 177,441 108,619 1,274,823 239,247
Page 34

Medicaid MCO Medicaid MCO Commercial MCO Commercial MCO Commercial MCO PACE Commercial MCO MH/SUD PIHP PCCM
State
GA HI HI HI HI HI HI IA IA
Plan
WellCare Aloha Care Evercare HMSA-Medical Kaiser Permanente Maui PACE Ohana Iowa Plan For Behavioral Health Medipass
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service
Operating Authority
1932(a) 1115 1115 1115 1115 PACE 1115 1915(b) 1932(a)

Atlanta Region, Central Region, East Region, North Region, Southeast Region, Southwest Region Statewide Statewide Big Island, Kauai, Oahu Maui, Oahu Maui Maui Statewide Adair, Adams, Allamakee, Appanoose, Audubon, Benton, Black Hawk, Boone, Bremer, Buchanan, Buena Vista, Butler, Calhoun, Carroll, Cass, Cedar, Cerro Gordo, Cherokee, Chickasaw, Clarke, Clay, Clayton, Clinton, Crawford, Dallas, Davis, Decatur, Delaware, Dickinson, Dubuque, Emmet, Fayette, Floyd, Franklin, Fremont, Greene, Grundy, Guthrie, Hamilton, Hancock, Hardin, Harrison, Henry, Howard, Humboldt, Ida, Jackson, Jasper, Jefferson, Johnson, Jones, Keokuk, Kossuth, Lee, Linn, Lucas, Lyon, Madison, Mahaska, Marion, Marshall, Mills, Mitchell, Monona, Monroe, Montgomery, Muscatine, O'Brien, Osceola, Page, Palo Alto, Plymouth, Pocahontas, Polk, Pottawattamie, Sac, Scott, Shelby, Sioux, Story, Tama, Taylor, Union, Van Buren, Warren, Wayne, Webster, Winnebago, Winneshiek, Woodbury, Worth, Wright Cherokee, Ida, Monona, Plymouth, Sioux, Woodbury Statewide Statewide
Number of Enrollees
421,656 68,037 18,494 97,164 22,223 17 22,239 329,897 170,659
IA ID ID
Siouxland PACE Blue Cross of Idaho Healthy Connections
PACE Dental PAHP PCCM
Risk-based Capitation Risk-based Capitation Fee-for-Service
PACE 1937 1937
55 129,308 166,524
Page 35

Medical-only PAHP
State
ID
Plan
Medicare-Medicaid Coordinated Plan
Operating Authority
1937

Ada, Bannock, Benewah, Boise, Bonner, Bonneville, Boundary, Canyon, Caribou, Cassia, Gem, Jefferson, Kootenai, Latah, Madison, Minidoka, Nez Perce, Oneida, Owyhee, Payette, Power, Shoshone, Twin Falls, Washington Cook Cook, Jackson, Kane, Madison, Perry, Randolph, St. Clair, Washington, Williamson Statewide Adams, Brown, Henry, Mercer, Pike, Rock Island, Scott Statewide Statewide Statewide Statewide Statewide Statewide Statewide Statewide Region 1 (NE/NCentral KS), Region 2 (SE/SCentral KS) Statewide Statewide Dogulas, Jackson, Jeffferson, Osage, Pottawatomie, Shawnee, Wabaunsee
Number of Enrollees
1,030
IL IL IL IL IN IN IN IN IN IN IN IN KS KS KS KS
Family Health Network Harmony Health Plan Illinois Health Connect Meridian Health Plan Advantage Health Solutions-Care Select Anthem-Healthy Indiana Plan Anthem-Hoosier Healthwise Enhanced Services Plan (ESP)-Healthy Indiana Plan Managed Health Services (MHS)-Hoosier Healthwise MDwise-Care Select MDwise-Healthy Indiana Plan MDwise-Hoosier Healthwise Children's Mercy's Family Health Partners HealthConnect Kansas Kansas Health Solutions Midland Care Services
Medicaid MCO Commercial MCO PCCM Medicaid MCO PCCM Commercial MCO Commercial MCO *High Risk Plan Medicaid MCO PCCM Commercial MCO Commercial MCO Medicaid MCO PCCM Mental Health PAHP PACE
Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Non-risk Capitation Risk-based Capitation
1915(a) 1915(a) 1932(a) 1915(a) 1915(b) 1115 1115, 1915(b) 1115 1115, 1915(b) 1915(b) 1115 1115, 1915(b) 1932(a) 1932(a) 1915(b)/(c) PACE
44,500 133,200 1,100,300 200 28,691 29,232 148,426 469 191,413 35,498 15,127 262,780 93,316 24,050 243,352 54
Page 36

Medicaid MCO Substance Use Disorders PIHP PACE Transp PAHP PCCM Medicaid MCO PCCM PACE
State
KS KS KS KY KY KY LA LA
Plan
UniCare Health Plan of Kansas, Inc. ValueOptions-Kansas Via Christi Healthcare Outreach Programs for Elders Human Service Transportation Kentucky Patient Access and Care (KenPAC) Passport Health Plan Community Care Greater New Orleans
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation Fee-For-Service Risk-based Capitation
Operating Authority
1932(a) 1915(b)/(c) PACE 1902(a)(70) 1932(a) 1115 1932(a) PACE

Statewide Statewide Sedgwick Statewide Statewide Jefferson County (Louisville) Kentucky and 15 surrounding counties Statewide 70001, 70002, 70003, 70005, 70006, 70032, 70043, 70053, 70112, 70113, 70114, 70115, 70116, 70117, 70118, 70119, 70121, 70122, 70124, 70125, 70126, 70127, 70128, 70129, 70130, 70131 Boston/Greater Boston Region, Central Region, Southern Region, Western Region Allston, Cambridge, Somerville East Boston Greater Boston Northeastern MA Central Region Statewide Boston/Greater Region, Central/Western Region, Northeast/Southeast Region
Number of Enrollees
47,684 243,352 173 638,083 304,973 159,005 729,219 119
MA MA MA MA MA MA MA MA
Boston Medical Center HealthNet Plan Elder Service Plan of Cambridge Health Alliance Elder Service Plan of East Boston Elder Service Plan of Harbor Health Services, Inc. Elder Service Plan of the North Shore, Inc. Fallon Community Health Plan MA Behavioral Health Partnership Neighborhood Health Plan
Medicaid MCO PACE PACE PACE PACE Commercial MCO MH/SUD PIHP Commercial MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115 PACE PACE PACE PACE 1115 1115 1115
181,342 194 297 293 652 12,259 304,821 135,287
Page 37

Medicaid MCO PCCM PACE PACE Medical-only PAHP Medicaid MCO PACE Medicaid MCO Medical-only PAHP Medicaid MCO Medical-only PAHP Medicaid MCO Medical-only PAHP Medicaid MCO Medicaid MCO Medicaid MCO
State
MA MA MA MA MD MD MD MD MD MD MD MD MD MD MD MD
Plan
Network Health Primary Care Clinician Plan Summit Elder Care Uphams Elder Service Plan AMERIGROUP - PAC AMERIGROUP Maryland Inc. Hopkins Elder Plus JAI Medical System JAI Medical Systems - PAC Maryland Physicians Care Maryland Physicians Care - PAC Medstar Family Choice Priority Partners - PAC Priority Partners MCO The Diamond Plan United Health Care
Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1115 1115 PACE PACE 1115 1115 PACE 1115 1115 1115 1115 1115 1115 1115 1115 1115

Boston/Greater Boston Region, Central/Western Region, Northeast/Southeast Region Statewide Worchester Boston Statewide except for Allegany and Washington Count Statewide except Allegany and Wahington Counties 21052, 21202, 21205, 21206, 21213, 21214, 21218, 21219, 21220, 21221, 21222, 21224, 21227, 21231, 21237 Baltimore City, Baltimore County Baltimore City, Baltimore County Statewide except Cecil County Statewide Anne Arundel North, Baltimore City, Baltimore County, Harford Statewide Statewide except North and East Baltimore County and Cecil County Baltimore City, Baltimore County, Cecil, Harford Statewide
Number of Enrollees
107,286 284,404 592 150 624 182,360 138 11,012 6,136 100,608 11,128 24,795 3,640 143,839 7,870 119,056
Page 38

Medical-only PAHP PCCM Mental Health PIHP Medicaid MCO PACE Medicaid MCO
State
MD ME MI MI MI MI
Plan
United HealthCare - PAC MaineCare Primary Care Case Management Access Alliance of Michigan BlueCaid of Michigan Care Resources CareSource of Michigan
Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Capitation Risk-based Capitation
Operating Authority
1115 1932(a) 1915(b) 1915(b) PACE 1915(b)

Statewide Statewide Arenac, Bay, Huron, Montcalm, Shiawassee, Tuscola Livingston, Washtenaw, Wayne Kent Alcona, Allegan, Alpena, Antrim, Arenac, Benzie, Berrien, Calhoun, Cass, Charlevoix, Cheboygan, Crawford, Genesee, Gladwin, Grand Traverse, Ionia, Iosco, Kalamazoo, Kalkaska, Kent, Lake, Leelanau, Manistee, Mason, Mecosta, Missaukee, Montmorency, Newaygo, Oceana, Ogemaw, Osceola, Oscoda, Ottawa, Presque Isle, Roscommon, Saginaw, St. Joseph, Van Buren Benzie, Clinton, Eaton, Gratiot, Ingham, Ionia, Manistee, Newago Clare, Gladwin, Isabella, Mecosta, Midland, Osceola Kent Calhoun Wayne Genesee Allegan, Berrien, Branch, Calhoun, Cass, Hillsdale, Huron, Jackson, Kalamazoo, Lenawee, Livingston, Macomb, Oakland, Saginaw, Sanilac, St. Clair, St. Joseph, Tuscola, Van Buren, Wayne
Number of Enrollees
8,818 178,353 54,216 20,128 154 48,143
MI MI MI MI MI MI MI
CMH Affiliation of Mid-Michigan CMH for Central Michigan CMHSA Network of West Michigan Comprehensive Senior Care Corporation Detroit-Wayne County CMH Agency Genesee County CMH Services Great Lakes Health Plan
Mental Health PIHP Mental Health PIHP Mental Health PIHP PACE Mental Health PIHP Mental Health PIHP Medicaid MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1915(b) 1915(b) 1915(b) PACE 1915(b) 1915(b) 1915(b)
84,957 39,138 88,718 18 400,370 84,805 193,811
Page 39

Medicaid MCO
State
MI
Plan
Health Plan of Michigan
Operating Authority
1915(b)

Allegan, Barry, Berrien, Branch, Calhoun, Cass, Clinton, Crawford, Eaton, Genesee, Hillsdale, Huron, Jackson, Kalamazoo, Kent, Lenawee, Livingston, Macomb, Manistee, Mason, Mecosta, Monroe, Montcalm, Muskegon, Newago, Oakland, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Roscommon, Saginaw, Sanilac, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren, Wayne Bay, Genesee, Lapeer, Saginaw, Shiawassee, Tuscola Alcona, Alger, Allegan, Alpena, Antrim, Arenac, Baraga, Barry, Benzie, Branch, Charlevoix, Cheboygan, Chippewa, Clare, Clinton, Crawford, Delta, Dickinson, Eaton, Emmet, Genesee, Gladwin, Gogebic, Gratiot, Hillsdale, Houghton, Huron, Ionia, Iosco, Iron, Isabella, Kalkaska, Keweenaw, Lake, Lapeer, Leelanau, Lenawee, Livingston, Luce, Mackinac, Manistee, Marquette, Menominee, Midland, Missaukee, Monroe, Montmorency, Ogemaw, Ontonagon, Oscoda, Otsego, Presque Isle, Roscommon, Saginaw, Sanilac, Schoolcraft, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren 48201, 48202, 48203, 48204, 48205, 48206, 48207, 48208, 48209, 48210, 48211, 48212, 48213, 48214, 48215, 48216, 48217, 48218, 48219, 48221, 48223, 48224, 48225, 48226, 48227, 48228, 48229, 48230, 48234, 48235, 48236, 48238, 48239, 48240 Muskegon, Ottawa Muskegon, Ottawa Hillsdale, Jackson Macomb Arenac, Bay, Clinton, Crawford, Eaton, Genesee, Gratiot, Ingham, Ionia, Isabella, Lapeer, Macomb, Montcalm, Oakland, Ogemaw, Oscoda, Roscommon, Saginaw, Shiawassee, Tuscola Livingston, Macomb, Oakland, St. Clair, Washtenaw, Wayne
Number of Enrollees
202,710
MI MI
HealthPlus Partners, Inc. Healthy Kids Dental
Medicaid MCO Dental PAHP
1915(b) 1915(b)
67,721 295,794
MI
Henry Ford Health System-Center for Senior Independence
PACE
PACE
194
MI MI MI MI MI
Lakeshore Behavioral Health Alliance Life Circles LifeWays Macomb County CMH Services McLaren Health Plan
Mental Health PIHP PACE Mental Health PIHP Mental Health PIHP Medicaid MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1915(b) PACE 1915(b) 1915(b) 1915(b)
58,964 21 31,591 87,717 71,083
MI
Midwest Health Plan
Medicaid MCO
1915(b)
66,934
Page 40

Medicaid MCO
State
MI
Plan
Molina Healthcare of Michigan
Operating Authority
1915(b)

Alcona, Allegan, Arenac, Bay, Benzie, Clare, Crawford, Genesee, Gladwin, Gratiot, Huron, Ionia, Iosco, Isabella, Kent, Lake, Macomb, Manistee, Mason, Mecosta, Midland, Missaukee, Monroe, Montcalm, Montmorency, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Sanilac, St. Clair, Tuscola, Wayne, Wexford Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keeweenau, Luce, Mackinac, Marquette, Menominee, Ontonagon, Schoolcraft Alcona, Alpena, Antrim, Charlevoix, Cheboygan, Emmet, Iosco, Kalkaska, Montmorency, Ogemaw, Oscoda, Otsego, Presque Isle Crawford, Grand Traverse, Lake, Leelanau, Mason, Missaukee, Oceana, Roscommon, Wexford Oakland Oakland, Wayne Ingham, Ionia, Montcalm, Shiawassee Allegan, Kent, Lake, Manistee, Mecosta, Montcalm, Muskegon, Oceana, Osceola, Ottawa Wayne Saginaw Lenawee, Livingston, Monroe, Washtenaw Allegan, Cass, Kalamazoo, St. Joseph Lapeer, Sanilac, St. Clair Genesee, Macomb, Oakland, Wayne
Number of Enrollees
205,469
MI
Northcare
Mental Health PIHP Mental Health PIHP Mental Health PIHP Mental Health PIHP Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO Mental Health PIHP Mental Health PIHP Mental Health PIHP Mental Health PIHP Medicaid MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1915(b)
41,636
MI
Northern Affiliation
1915(b)
43,437
MI MI MI MI MI MI MI MI MI MI MI
Northern Lakes CMH Authority Oakland County CMH Authority Omnicare Health Plan Physicians Health Plan of Mid-Michigan Family Care Priority Health Government Programs, Inc. ProCare Health Plan Saginaw County CMH Authority Southeast Partnership Southwest Alliance Thumb Mental Health Alliance Total Health Care
1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b)
40,434 95,564 54,184 17,843 59,560 1,113 38,276 67,544 67,132 41,820 53,576
Page 41

Medicaid MCO
State
MI
Plan
Upper Peninsula Health Plan
Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1915(b)

Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keewenaw, Luce, Mackinac, Marquette, Menominee, Ontonagon, Schoolcraft Barry, Berrien, Branch, Calhoun, VanBuren Aitkin, Anoka, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carver, Cass, Chippewa, Chisago, Clay, Clearwater, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore, Freeborn, Goodhue, Grant, Hennepin, Houston, Hubbard, Isanti, Itasca, Jackson, Kanabec, Kandiyohi, Kittson, Lac Qui Parle, Lake of the Woods, LeSueur, Lincoln, Lyon, Mahnomen, Marshall, Martin, Mcleod, Meeker, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Pine, Pipestone, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Rice, Rock, Rouseau, Scott, Sherburne, Sibley, Stearns, Steele, Stevens, Swift, Todd, Traverse, Wabasha, Wadena, Waseca, Washington, Watonwan, Wilkin, Winona, Wright, Yellow Medicine Carlton, Cook, Koochiching, Lake, St. Louis
Number of Enrollees
26,540
MI MN
Venture Behavioral Health Blue Plus
Mental Health PIHP Commercial MCO
1915(b) 1115, 1932(a), 1915(a), 1915(b)/(c)
81,054 99,354
MN
First Plan Blue
Commercial MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115, 1932(a), 1915(a), 1915(b)/(c) 1115, 1932(a), 1915(a), 1915(b)/(c) 1115, 1932(a), 1915(a), 1915(b)/(c) 1115, 1932(a), 1915(a), 1915(b)/(c)
8,679
MN
Health Partners
Commercial MCO
Anoka, Benton, Carver, Chisago, Dakota, Hennepin, McLeod, Meeker, Ramsey, Scott, Sherburne, Stearns, Washington, Wright Aitkin, Itasca, Koochiching
45,170
MN
Itasca Medical Care
Medicaid MCO
5,017
MN
Medica
Commercial MCO
Aitkin, Anoka, Becker, Benton, Carlton, Carver, Cass, Chisago, Clay, Crow Wing, Dakota, Hennepin, Isanti, Koochiching, Lake, Mahnomen, Mille Lacs, Morrison, Norman, Otter Tail, Pine, Polk, Ramsey, Rice, Scott, Sherburne, St. Louis, Stearns, Todd, Wadena, Washington, Wilkin, Wright Anoka, Carver, Hennepin, Mower, Polk, Scott
119,185
MN
Metropolitan Health Plan
Commercial MCO
1115, 1932(a), 1915(a), 1915(b)/(c)
14,352
Page 42

Medicaid MCO
State
MN
Plan
PrimeWest Health System
Operating Authority
1115, 1932(a), 1915(a), 1915(b)/(c) 1115, 1932(a), 1915(a), 1915(b)/(c) 1115, 1932(a), 1915(a), 1915(b)/(c)

Beltrami, Big Stone, Clearwater, Douglas, Grant, Hubbard, McLeod, Meeker, Pipestone, Pope, Renville, Stevens, Traverse Brown, Cass, Crow Wing, Dodge, Freeborn, Goodhue, Kanabec, Morrison, Sibley, Steele, Todd, Wabasha, Wadena, Waseca Aitkin, Anoka, Benton, Big Stone, Blue Earth, Brown, Carlton, Carver, Cass, Chippewa, Chisago, Cook, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore, Freeborn, Goodhue, Grant, Hennepin, Houston, Isanti, Jackson, Kanabec, Kandiyohi, Kittson, Koochiching, Lac Qui Parle, Lake, LeSueur, Lincoln, Lyon, Marshall, Martin, McLeod, Meeker, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Pine, Pipestone, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Rice, Rock, Roseau, Scott, Sherburne, Sibley, St. Louis, Stearns, Steele, Stevens, Swift, Todd, Traverse, Wabasha, Wadena, Waseca, Washington, Watonwan, Winona, Wright, Yellow Medicine St. Louis City, St. Louis County Cass, Clay, Henry, Jackson, Johnson, Lafayette, Platte, Ray, St. Clair Bates, Cass, Cedar, Clay, Henry, Jackson, Johnson, Lafayette, Platte, Polk, Ray, St. Clair, Vernon Franklin, Jefferson, Lincoln, Madison, Perry, Pike, St. Charles, St. Francois, St. Louis, St. Louis City, Ste. Genevieve, Warren, Washington Audrain, Bates, Benton, Boone, Callaway, Camden, Cass, Cedar, Chariton, Clay, Cole, Cooper, Franklin, Gasconade, Henry, Howard, Jackson, Jefferson, Johnson, Laclede, Lafayette, Lincoln, Linn, Macon, Maries, Marion, Miller, Moniteau, Monroe, Montgomery, Morgan, Osage, Pettis, Phelps, Pike, Platte, Polk, Pulaski, Ralls, Randolph, Ray, Saline, Shelby, St. Charles, St. Clair, St. Francois, St. Louis, St. Louis City, Ste. Genevieve, Vernon, Warren, Washington Statewide
Number of Enrollees
18,248
MN
South Country Health Alliance
Medicaid MCO
27,698
MN
UCARE
Commercial MCO
88,306
MO MO MO MO
Alexian Brothers Community Services Blue Advantage Plus of Kansas City Childrens Mercy Family Health Partners Harmony Health Plan of Missouri
PACE Medicaid MCO Medicaid MCO Medicaid MCO
PACE 1915(b) 1915(b) 1915(b)
183 29,057 51,512 15,318
MO
HealthCare USA
Medicaid MCO
1915(b)
187,157
MO
LogistiCare Solutions, LLC
Transp PAHP
1902(a)(70)
481,926
Page 43

Medicaid MCO
State
MO
Plan
Missouri Care
Operating Authority
1915(b)

Audrain, Benton, Boone, Callaway, Camden, Chariton, Cole, Cooper, Gasconade, Howard, Laclede, Linn, Macon, Maries, Marion, Miller, Moniteau, Monroe, Montgomery, Morgan, Osage, Pettis, Phelps, Pulaski, Ralls, Randolph, Saline, Shelby Audrain, Bates, Benton, Boone, Callaway, Camden, Cass, Cedar, Chariton, Clay, Cole, Cooper, Franklin, Gasconade, Henry, Howard, Jackson, Jefferson, Johnson, Laclede, Lafayette, Lincoln, Linn, Macon, Madison, Maries, Marion, Miller, Moniteau, Monroe, Montgomery, Morgan, Osage, Perry, Pettis, Phelps, Pike, Platte, Polk, Pulaski, Ralls, Randolph, Ray, Saline, Shelby, St. Charles, St. Clair, St. Francois, St. Louis, St. Louis City, Ste. Genevieve, Vernon, Warren, Washington Statewide 59002, 59006, 59015, 59024, 59037, 59044, 59047, 59064, 59079, 59088, 59101, 59102, 59105, 59106 Statewide
Number of Enrollees
40,763
MO
Molina Healthcare of Missouri
Medicaid MCO
1915(b)
77,507
MS MT MT
LogistiCare Soultions, LLC Billings Clinic McKesson Health Solutions
Transp PAHP PACE Disease Management PAHP PCCM PCCM PCCM PACE MH/SUD PIHP PACE Disease Management PAHP PACE
Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Fee-For-Service Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1902(a)(70) PACE 1915(b)
512,796 24 368
MT NC NC NC NC NC ND
Passport to Health Carolina Access Community Care of North Carolina (Access II/III) Elderhaus Piedmont Cardinal Health Plan Piedmont SeniorCare ExperienceHealth ND
1915(b) 1932(a) 1932(a) PACE 1915(b)/(c) PACE 1915(b)
Statewide Statewide Statewide Brunswick, New Hanover Rowan, Stanly, Davidson, Union and Cabarrus Counties Caswell, Yancy Statewide
371 77,803 921,106 26 72,734 24 2,427
ND
Northland PACE
PACE
58501, 58502, 58503, 58504, 58554, 58558, 58601, 58602, 58652, 58655, 58656
25
Page 44

PCCM *Specialty Physician Case Management (SPCM) Program PCCM Commercial MCO Disease Management PAHP Commercial MCO Medicaid MCO
State
ND NE
Plan
Primary Care Case Management Magellan Behavioral Health
Fee-For-Service Fee-For-Service
Operating Authority
1932(a) 1915(b)

Statewide Statewide
Number of Enrollees
29,339 179,512
NE NE NH
Primary Care Plus Share Advantage McKesson Health Solutions
Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1915(b), 1932(a) 1915(b), 1932(a) 1915(b)
Douglas, Lancaster, Sarpy Douglas, Lancaster, Sarpy Statewide
38,623 36,119 96,553
NJ NJ
AmeriChoice of New Jersey, Inc. AMERIGROUP New Jersey, Inc.
1915(b), 1932(a) 1915(b), 1932(a)
Statewide Atlantic, Bergen, Burlington, Camden, Cape May, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, Sussex, Union, Warren Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Union Statewide 08002, 08003, 08004, 08007, 08009, 08012, 08021, 08026, 08029, 08030, 08031, 08033, 08034, 08035, 08043, 08045, 08049, 08059, 08078, 08081, 08083, 08084, 08091, 08095, 08099, 08101, 08102, 08103, 08104, 08105, 08106, 08107, 08108, 08109, 08110 08505, 08518, 08554 Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, Union, Warren Statewide
222,083 90,055
NJ
Health Net of New Jersey, Inc.
Medicaid MCO
1915(b), 1932(a)
41,914
NJ NJ
Horizon NJ Health Life at Loudes
Medicaid MCO PACE
1915(b), 1932(a) PACE
324,911 14
NJ NJ
Life St. Francis University Health Plans, Inc.
PACE Commercial MCO
PACE 1915(b), 1932(a)
17 46,651
NM
AMERIGROUP Community Care of New Mexico, Inc.
Commercial MCO
1915(b)/(c)
19,080
Page 45

Commercial MCO Commercial MCO Commercial MCO Medicaid MCO Commercial MCO PACE Mental Health PIHP Medicaid MCO Commercial MCO Transp PAHP Medicaid MCO Commercial MCO Medicaid MCO Long Term Care PIHP PCCM Commercial MCO
State
NM NM NM NM NM NM NM NV NV NV NY NY NY NY NY NY
Plan
Blue Cross Blue Shield of New Mexico Evercare of New Mexico Lovelace Community Health Plan Molina Healthcare of New Mexico Presbyterian Health Plan Total Community Care (PACE) ValueOptions of New Mexico Amerigroup Community Care Health Plan of Nevada Logisticare Affinity Health Plan Affinity/Medicaid Advantage Amerigroup Amerigroup Community Connections Broome County MC Capital District Physicians Health Plan
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Risk-based Capitation
Operating Authority
1915(b) 1915(b)/(c) 1915(b) 1915(b) 1915(b) PACE 1915(b) 1932(a) 1932(a) 1932(a) 1115 1115 1115 1915(a) 1115 1115

Statewide Statewide Statewide Statewide Statewide Bernalillo County, Sandoval County, Valencia County Statewide Statewide Clark, Washoe Statewide Bronx, Kings, Nassau, New York, Orange, Queens, Richmond, Rockland, Suffolk, Westchester Statewide New York City, Putnam New York City Broome Albany, Broome, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Tioga, Washington
Number of Enrollees
9,560 17,891 80,679 69,035 148,732 376 312,498 46,921 59,381 178,711 204,166 81 98,618 585 3,366 53,410
Page 46

Long Term Care PIHP PACE PACE Commercial MCO
State
NY NY NY NY
Plan
CCM Select Comprehensive Care Management (CCM) Eddy Senior Care Excellus
Operating Authority
1915(a) PACE PACE 1115

Statewide New York City, Westchester Albany, Schenectady Broome, Chemung, Clinton, Essex, Franklin, Herkimer, Livingston, Madison, Monroe, Oneida, Onondaga, Ontario, Orleans, Oswego, Otsego, Seneca, St Lawrence, Wayne, Yates Statewide Albany, Bronx, Broome, Columbia, Delaware, Dutchess, Greene, Kings, Manhattan, Montgomery, Orange, Otsego, Putnam, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Sullivan, Ulster, Warren, Washington, Westchester Statewide New York City Statewide Orange Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk Albany, Allegany, Cattauragus, Chautauqua, Clinton, Columbia, Erie, Essex, Fulton, Genesee, Greene, Montgomery, Niagara, Orleans, Rensselaer, Saratoga, Schenectady, Warren, Washington, Wyoming Statewide Bronx, Kings, New York, Queens, Richmond
Number of Enrollees
1,254 2,488 113 105,454
NY NY
GHI GHI HMO Select
*PPO Commercial MCO
1115 1115
6,148 36,547
NY NY NY NY NY NY
GHI/Medicaid Advantage Guildnet GuildNet/Medicaid Advantage Plus Health Advantage/Elant Choice Health First Health Now
Commercial MCO Long Term Care PIHP Long Term Care PIHP Long Term Care PIHP Medicaid MCO Commercial MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115 1915(a) 1915(a) 1915(a) 1115 1115
940 6,522 162 136 381,548 39,462
NY NY
Health Now/Medicaid Advantage HealthPlus
Commercial MCO Medicaid MCO
1115 1115
166 258,988
Page 47

Long Term Care PIHP Commercial MCO Commercial MCO Long Term Care PIHP Medicaid MCO Long Term Care PIHP Commercial MCO PACE Commercial MCO Commercial MCO Medicaid MCO Medicaid MCO Commercial MCO Commercial MCO Commercial MCO Medicaid MCO
State
NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY
Plan
HHH Choices HIP Combined HIP Health Plan/Medicaid Advantage HomeFirst Hudson Health Plan Independent Care Systems Independent Health/Hudson Valley&WNY Independent Living For Seniors Liberty Health Advantage/Medicaid Advantage Managed Health Inc/Medicaid Advantage MetroPlus Health Plan MetroPlus Health Plan Special Needs MetroPlus/Medicaid Advantage MVP Health Plan Neighborhood Health Provider/Medicaid Advantage Neighborhood Health Providers
Operating Authority
1915(a) 1115 1115 1915(a) 1115 1915(a) 1115 PACE 1115 1115 1115 1115 1115 1115 1115 1115

Statewide Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk, Westchester Statewide New York City Dutchess, Orange, Rockland, Sullivan, Ulster, Westchester New York City Erie, Niagara Monroe Statewide Statewide Bronx, Kings, New York, Queens Bronx, Brooklyn, Manhattan, Queens Statewide Dutchess, Ulster Statewide Bronx, Kings, New York, Queens, Richmond
Number of Enrollees
754 255,511 1,950 3,236 64,812 1,369 31,030 253 703 51 339,331 2,962 8 32,276 195 199,517
Page 48

Medicaid MCO Commercial MCO Medicaid MCO
State
NY NY NY
Plan
NYPS Select Health Special Needs NYS Catholic Health Plan 1199 NYS Catholic Health Plan/Fidelis
Operating Authority
1115 1115 1115

Statewide Statewide Albany, Bronx, Broome, Cattauragus, Chautauqua, Clinton, Columbia, Cortland, Dutchess, Erie, Essex, Greene, Hamilton, Herkimer, Kings, Nassau, New York, Niagara, Oneida, Onondaga, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Suffolk, Warren, Washington, Westchester Statewide Onondaga Orange, Rockland Erie Onondaga, Oswego, Tompkins New York City Statewide Statewide Statewide Chemung, Steuben Chemung, Schuyler, Steuben Erie
Number of Enrollees
1,334 4,219 393,919
NY NY NY NY NY NY NY NY NY NY NY NY
NYS Catholic Health Plan/Fidelis/Medicaid Advantage PACE CNY Partners In Community Care Physician Case Management Program SCHC TotalCare Senior Health Partners Senior Network Health Senior Whole Health Medicaid Advantage Plus Senior Whole Health/ Medicaid Advantage Southern Tier Pediatrics Southern Tier Priority Total Aging in Place
Commercial MCO PACE Long Term Care PIHP PCCM Medicaid MCO Long Term Care PIHP Long Term Care PIHP Long Term Care PIHP Commercial MCO PCCM PCCM Long Term Care PIHP
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115 PACE 1915(a) 1115 1115 1915(a) 1915(a) 1915(a) 1115 1115 1115 1915(a)
240 340 270 4,947 31,284 1,599 378 135 599 4,050 4,276 147
Page 49

PACE Commercial MCO Commercial MCO Medicaid MCO Medicaid MCO Long Term Care PIHP Long Term Care PIHP Commercial MCO Long Term Care PIHP Long Term Care PIHP Medicaid MCO Medicaid MCO Medicaid MCO PACE Medicaid MCO Medicaid MCO
State
NY NY NY NY NY NY NY NY NY NY OH OH OH OH OH OH
Plan
Total Senior Care Touchstone/Prestige/Medicaid Advantage United Healthcare Univera Community Health VidaCare Inc. Special Needs VNS Choice VNS Choice Plus/Medicaid Advantage Plus Wellcare WellCare Advantage Plus/Medicaid Advantage Plus WellCare Advocate Amerigroup Ohio Buckeye Community Health Plan CareSource Concordia Care Molina Healthcare of Ohio Paramount Advantage
Operating Authority
PACE 1115 1115 1115 1115 1915(a) 1915(a) 1115 1915(a) 1915(a) 1932(a) 1932(a) 1932(a) PACE 1932(a) 1932(a)

Cattaraugus Statewide Bronx, Kings, Nassau, Queens, Richmond, Suffolk Allegany, Cattaraugus, Chautauqua, Erie Bronx, Brooklyn, Manhattan, Queens, Staten Island New York City Statewide Albany, Bronx, Columbia, Dutchess, Greene, Kings, New York, Orange, Queens, Rensselaer, Rockland, Sullivan, Ulster Statewide Statewide Southwest, West Central East Central, Northeast, Northwest, Southwest Central, East Central, Northeast, Northeast Central, Northwest, Southeast, Southwest, West Central Cuyahoga Central, Southeast, Southwest, West Central Northwest
Number of Enrollees
16 551 209,812 36,123 1,374 7,375 21 89,419 127 283 59,762 140,296 689,818 238 201,551 76,841
Page 50

PACE Medicaid MCO Medicaid MCO PACE PCCM PCCM Transp PAHP Mental Health PIHP Dental PAHP
State
OH OH OH OK OK OK OK OR OR
Plan
TriHealth Senior Link Unison Health Plan of Ohio WellCare of Ohio Cherokee Elder Care SoonerCare American Indian PCCM SoonerCare PCCM SoonerRide Accountable Behavioral Health Capitol Dental Care Inc.
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
PACE 1932(a) 1932(a) PACE 1115 1115 1902(a)(70) 1115 1115

Butler, Clermont, Hamilton, Warren East Central, Northeast Central, Southeast Northeast 74347, 74352, 74364, 74368, 74401, 74423, 74427, 74434, 74441, 74451, 74452, 74464, 74471 Statewide Statewide Statewide Benton, Crook, Deschutes, Jefferson, Lincoln Benton, Clackamas, Clatsop, Columbia, Hood River, Jackson, Josephine, Klamath, Lane, Lincoln, Linn, Marion, Morrow, Multnomah, Polk, Umatilla, Union, Wasco, Washington, Yamhill Clackamas, Clatsop, Columbia, Coos, Douglas, Jackson, Klamath, Marion, Morrow, Multnomah, Polk, Umatilla, Washington, Yamhill Klamath Crook, Deschutes, Grant, Harney, Hood River, Jefferson, Klamath, Lake, Sherman, Wasco, Wheeler Clackamas, Gilliam, Hood River, Marion, Sherman, Wasco Deschutes Coos Douglas
Number of Enrollees
454 108,213 97,347 49 11,831 400,642 553,385 30,076 131,921
OR
Care Oregon
Medicaid MCO
1115
114,606
OR OR OR OR OR OR
Cascade Comprehensive Care Central Oregon Independent Health Solutions Clackamas County Mental Health Deschutes County CDO Doctors of the Oregon Coast South Douglas County IPA
Medicaid MCO Medicaid MCO Mental Health PIHP Substance Use Disorders PAHP Medicaid MCO Commercial MCO
1115 1115 1115 1115 1115 1115
6,678 22,859 27,427 15,615 8,444 12,369
Page 51

Mental Health PIHP Commercial MCO Mental Health PIHP Dental PAHP
State
OR OR OR OR
Plan
FamilyCare (Mental Health) FamilyCare Health Plans Greater Oregon Behavioral Health, Inc. Hayden Family Dentistry
Operating Authority
1115 1115 1115 1115

Clackamas, Multnomah, Washington Clackamas, Jackson, Josephine, Morrow, Multnomah, Umatilla, Washington Baker, Clatsop, Columbia, Grant, Harney, Lake, Malheur, Morrow, Umatilla, Union, Wallowa, Wheeler Benton, Clackamas, Coos, Crook, Deschutes, Douglas, Gilliam, Grant, Harney, Jackson, Jefferson, Klamath, Lake, Lane, Lincoln, Linn, Marion, Morrow, Multnomah, Polk, Sherman, Umatilla, Wasco, Wheeler Benton, Linn Coos, Curry, Douglas, Jackson, Josephine, Klamath Clackamas, Marion, Multnomah, Polk Lane Benton, Lane, Linn Benton, Clackamas, Clatsop, Columbia, Hood River, Jackson, Josephine, Linn, Marion, Multnomah, Polk, Tillamook, Washington, Yamhill Benton, Clackamas, Linn, Marion, Polk, Yamhill Linn, Marion, Polk, Tillamook, Yamhill Douglas, Jackson, Josephine Clackamas, Multnomah, Washington Multnomah
Number of Enrollees
12,727 23,132 46,127 60,900
OR OR OR OR OR OR
Inter-Community Health Network Jefferson Behavioral Health Kaiser Permanente Oregon Plus Lane Care MHO Lane Individual Practice Association Managed Dental Care of Oregon
Medicaid MCO Mental Health PIHP Medicaid MCO Mental Health PIHP Medicaid MCO Dental PAHP
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
1115 1115 1115 1115 1115 1115
17,999 55,904 6,355 38,210 31,541 10,509
OR OR OR OR OR
Marion Polk Community Health Plan Mid Valley Behavioral Care Network Mid-Rogue Independent Practice Assoc. Multicare Dental Multnomah County Verity
Medicaid MCO Mental Health PIHP Medicaid MCO Dental PAHP Mental Health PIHP
1115 1115 1115 1115 1115
45,642 79,755 12,880 28,057 74,430
Page 52

Dental PAHP
State
OR
Plan
Northwest Dental Services
Operating Authority
1115

Baker, Coos, Crook, Curry, Deschutes, Douglas, Grant, Harney, Hood River, Jackson, Jefferson, Josephine, Klamath, Lake, Lane, Malheur, Sherman, Umatilla, Union, Wallowa, Wasco, Wheeler Baker, Deschutes, Jackson, Malheur, Union, Wallowa Baker, Benton, Clackamas, Clatsop, Columbia, Crook, Deschutes, Grant, Hood River, Jackson, Jefferson, Josephine, Lane, Linn, Malheur, Marion, Multnomah, Polk, Tillamook, Umatilla, Wasco, Washington, Yamhill Douglas, Jackson, Josephine Statewide 97009, 97010, 97014, 97019, 97024, 97030, 97034, 97035, 97056, 97060, 97080, 97124, 97133, 97201, 97202, 97203, 97204, 97205, 97206, 97209, 97210, 97211, 97212, 97213, 97215, 97216, 97217, 97218, 97219, 97220, 97221, 97222, 97225, 97227, 97229, 97230, 97231, 97232, 97233, 97236, 97239, 97258, 97266 Clackamas, Multnomah, Washington, Yamhill Washington Washington Benton, Clackamas, Deschutes, Douglas, Jackson, Josephine, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Tillamook, Washington Bedford, Blair, Bradford, Cambria, Cameron, Carbon, Centre, Clarion, Clearfield, Clinton, Columbia, Crawford, Elk, Erie, Forest, Franklin, Fulton, Huntingdon, Jefferson, Juniata, Lackawanna, Luzerne, Lycoming, McKean, Mercer, Mifflin, Monroe, Montour, Northumberland, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Wayne, Wyoming Clinton, Lancaster, Lycoming
Number of Enrollees
58,028
OR OR
ODS Community Health Inc. Oregon Dental Service
Medicaid MCO Dental PAHP
1115 1115
7,232 48,745
OR OR OR
Oregon Health Management Service PCCM Providence Elder Place
Medicaid MCO PCCM PACE
Risk-based Capitation Fee-For-Service Risk-based Capitation
1115 1115 PACE
4,351 12,207 555
OR OR OR OR
Providence Health Assurance Tuality Health Care Washington County Health (Mental Health) Willamette Dental
Medicaid MCO Medicaid MCO Mental Health PIHP Dental PAHP
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service
1115 1115 1115 1115
17,183 7,276 34,889 56,673
PA
Access Plus Program
PCCM
1915(b)
262,583
PA
Albright LIFE
Medical-only PIHP
1915(a)
46
Page 53

Commercial MCO Commercial MCO Commercial MCO MH/SUD PIHP MH/SUD PIHP PACE
State
PA PA PA PA PA PA
Plan
AmeriChoice of Pennsylvania AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan - VOL Community Care Behavioral Health North Central Community Care Behavioral Health Northeast Community LIFE
Operating Authority
1915(b) 1915(b) 1915(a) 1915(b) 1915(b) PACE

Bucks, Chester, Delaware, Montgomery, Philadelphia Adams, Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton, Perry, York Carbon, Lackawanna, Luzerne, Monroe, Pike Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniat Lackawanna, Luzerne, Susquehanna, Wyoming 14145, 15014, 15018, 15020, 15024, 15025, 15028, 15030, 15032, 15034, 15035, 15037, 15045, 15047, 15049, 15051, 15065, 15075, 15076, 15084, 15088, 15102, 15104, 15110, 15112, 15120, 15122, 15129, 15131, 15132, 15133, 15135, 15137, 15139, 15140, 15144, 15146, 15147, 15148, 15206, 15207, 15208, 15215, 15217, 15218, 15221, 15227, 15232, 15234, 15235, 15236, 15238, 15239 Armstrong, Indiana Bedford
Number of Enrollees
57,378 87,673 2,262 121,194 74,059 298
PA PA
Counties of Armstrong/Indiana - Value Behavioral Health of PA Counties of Bedford/Somerset Community Behavioral Healthcare Network of Pennsylvania Counties of Carbon/Monroe/Pike Community Care Behavioral Health Counties of Crawford/Mercer/Venango Value Behavioral Health Counties of Franklin/Fulton - Community Behavorial Healthcare Network of Pennsylvania Counties of Lycoming/Clinton Community Behavioral Healthcare Network of Pennsylvania County of Adams - Community Care Behavioral Health County of Allegheny - Community Care Behavioral Health
MH/SUD PIHP MH/SUD PIHP
1915(b) 1915(b)
17,134 13,280
PA PA PA
MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP
1915(b) 1915(b) 1915(b)
Carbon, Monroe, Pike Crawford, Mercer, Venango Franklin, Fulton
30,595 35,594 13,874
PA
MH/SUD PIHP
1915(b)
Clinton, Lycoming
18,341
PA PA
MH/SUD PIHP MH/SUD PIHP
1915(b) 1915(b)
Adams Allegheny
6,971 133,123
Page 54

MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP
State
PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA
Plan
County of Beaver - Value Behavioral Health of PA County of Berks - Community Care Behavioral Health County of Blair County - Community Behavioral Healthcare Network of PA County of Bucks - Magellan Behavioral Health County of Butler - Value Behavioral Health of PA County of Cambria - Value Behavioral Health County of Chester - Community Care Behavioral Health County of Cumberland - Community Behavioral Healthcare Network of PA, Inc. County of Dauphin - Community Behavioral Healthcare Network of PA, Inc. County of Delaware - Magellan Behavioral Health County of Erie - Value Behavioral Health County of Fayette - Value Behavioral Health of PA County of Lancaster - Community Behavioral Healthcare Network of PA, Inc. County of Lawrence - Value Behavioral Health of PA County of Lebanon - Community Behavioral Healthcare Network of PA, Inc. County of Lehigh - Magellan Behavioral Health
Operating Authority
1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b)

Beaver Berks Blair Bucks Butler Cambria Chester Cumberland Dauphin Delaware Erie Fayette Lancaster Lawrence Lebanon Lehigh
Number of Enrollees
19,792 48,242 17,435 35,983 13,462 17,308 24,311 13,100 30,360 56,058 39,483 24,132 44,157 12,361 12,248 41,315
Page 55

MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP MH/SUD PIHP PACE Commercial MCO
State
PA PA PA PA PA PA PA PA PA
Plan
County of Montgomery - Magellan Behavioral Health County of Northampton - Magellan Behavioral Health County of Perry - Community Behavioral Healthcare Network of PA, Inc. County of Philadelphia - Community Behavioral Health County of Washington - Value Behavioral Health of PA County of Westmoreland - Value Behavioral Health of PA County of York - Community Care Behavioral Health Everyday LIFE Gateway Health Plan, Inc.
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) PACE 1915(b)

Montgomery Northampton Perry Philadelphia Washington Westmoreland York Lehigh, Northampton Adams, Allegheny, Armstrong, Beaver, Berks, Butler, Cumberland, Dauphin, Fayette, Greene, Indiana, Lancaster, Lawrence, Lebanon, Lehigh, Northampton, Perry, Washington, Westmoreland, York Blair, Cambria, Carbon, Clarion, Columbia, Erie, Franklin, Jefferson, Lackawanna, Luzerne, Mercer, Monroe, Montour, Northumberland, Pike, Schuylkill, Somerset, Susquehanna, Wyoming Bucks, Chester, Delaware, Montgomery, Philadelphia Bucks, Chester, Delaware, Montgomery, Philadelphia Beaver Lackawanna, Luzerne, Montour, Northumberland, Schuylkill, Snyder, Union, Wyoming
Number of Enrollees
47,007 25,482 3,517 353,115 20,798 35,123 37,574 5 192,419
PA
Gateway Health Plan, Inc. -VOL
Commercial MCO
1915(a)
19,681
PA PA PA PA
Health Partners of Philadelphia Keystone Mercy Health Plan LIFE - Beaver County LIFE - Geisinger
Commercial MCO Commercial MCO PACE PACE
1915(b) 1915(b) PACE PACE
124,518 263,884 122 98
Page 56

PACE
State
PA
Plan
LIFE - Pittsburgh
Operating Authority
PACE

15006, 15007, 15015, 15017, 15031, 15044, 15046, 15056, 15064, 15071, 15082, 15086, 15090, 15091, 15101, 15106, 15108, 15116, 15126, 15127, 15136, 15142, 15143, 15201, 15202, 15203, 15204, 15205, 15209, 15210, 15211, 15212, 15213, 15214, 15216, 15219, 15220, 15222, 15223, 15224, 15225, 15226, 15228, 15229, 15233, 15237, 15241, 15243 19103, 19104, 19121, 19130, 19131, 19139, 19142, 19143, 19151, 19153 Chester, Delaware Butler Franklin Erie Philadelphia Bedford, Blair, Bradford, Cambria, Cameron, Carbon, Centre, Clarion, Clearfield, Clinton, Columbia, Crawford, Elk, Erie, Forest, Franklin, Fulton, Huntington, Jefferson, Juniata, Lackwanna, Luzerne, Lycoming, McKean, Mercer, Mifflin, Monroe, Montour, Northumberland, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Wayne, Wyoming 19106, 19107, 19111, 19114, 19115, 19116, 19123, 19124, 19125, 19134, 19135, 19136, 19137, 19145, 19146, 19147, 19148, 19149, 19152, 19154 Philadelphia County zip codes 19118, 19119, 19120, 19126, 19127, 19128, 19129, 19132, 19138, 19141, Blair, Cambria, Dauphin, Somerset County zip codes 15531, 15928, 15935, 15953 and 15963, Westmoreland County zip codes 15944 and 15954, York Adams, Allegheny, Armstrong, Beaver, Berks, Butler, Cumberland, Dauphin, Fayette, Greene, Indiana, Lancaster, Lawrence, Lebanon, Lehigh, Northampton, Perry, Washington, Westmoreland, York
Number of Enrollees
320
PA PA PA PA PA PA PA
LIFE - University of Pennsylvania LIFE at Home LIFE Butler County LIFE Lutheran Services LIFE NWPA Logisticare Solutions, LLC McKesson Health Solutions
PACE PACE Medical-only PIHP PACE Medical-only PIHP Transp PAHP Disease Management PAHP
PACE PACE 1915(a) PACE 1915(a) 1902(a)(70) 1915(b)
341 59 16 15 28 406,732 50,788
PA
Mercy LIFE
PACE
PACE
234
PA PA
New Courtland LIFE Senior LIFE Johnstown
Medical-only PIHP PACE
1915(a) PACE
113 145
PA
Unison Health Plan / MedPLUS
Commercial MCO
1915(b)
90,679
Page 57

Commercial MCO
State
PA
Plan
Unison Health Plan/MedPlus - VOL
Operating Authority
1915(a)

Blair, Bradford, Cambria, Carbon, Clarion, Columbia, Crawford, Erie, Forest, Franklin, Jefferson, Lackawanna, Luzerne, Mercer, Monroe, Montour, Pike, Schuylkill, Somerset, Sullivan, Susquehanna, Warren, Wyoming Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence, Washington, Westmoreland Bedford, Blair, Cambria, Clearfield, Crawford, Mercer, Somerset, Venango Greene Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamn, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Marias, Las Piedras, Lioza, Luquillo, Manat, Maricao, Maunabo, Mayagez, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincon, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastian, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco Aguas Buenas, Arecibo, Barceloneta, Caguas, Camuy, Canovanas, Carolina, Cayey, Ceiba, Ciales, Cidra, Culebra, Fajardo, Florida, Gurabo, Hatillo, Humacao, Juncos, Lares, Las Piedras, Loiza, Luquillo, Manati, Morovis, Naguabo, Quebradillas, Rio Grande, San Lorenzo, Trujillo Alto, Utuado, Vega Baja, Vieques, Yabucoa Adjuntas, Aibonito, Arroyo, Barranquitas, Coamo, Guanica, Guayama, Guayanilla, Jayuya, Juana Diaz, Maunabo, Orocovis, Patillas, Penuelas, Ponce, Salinas, Santa Isabel, Villalba, Yauco Aguas Buenas, Aibonito, Arroyo, Barranquitas, Caguas, Cayey, Cidra, Coamo, Guayama, Gurabo, Humacao, Juana Diaz, Juncos, Las Piedras, Maunabo, Naguabo, Orocovis, Patillas, Salinas, San Lorenzo, Santa Isabel, Villalba, Yabucoa
Number of Enrollees
30,188
PA PA PA PR
UPMC Health Plan, Inc./UPMC for You UPMC Health Plan, Inc./UPMC for You VOL Value Behavioral Health of PA (Greene County) American Health Medicare
Commercial MCO Commercial MCO MH/SUD PIHP Commercial MCO
1915(b) 1915(a) 1915(b) 1915(a)
90,899 5,607 5,998 14,134
PR
APS Healthcare
MH/SUD PIHP
1915(a)
323,126
PR
FHC Healthcare
MH/SUD PIHP
1915(a)
182,176
PR
Humana Health Plans of Puerto Rico, Inc.
Commercial MCO
1915(a)
210,422
Page 58

Commercial MCO
State
PR
Plan
Humana Puerto Rico
Operating Authority
1915(a)

Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamn, Cabo Rojo, Caguas, Camuy, Canvanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comero, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Marias, Las Piedras, Loza, Luquillo, Manat, Maricao, Maunabo, Mayaguz, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincon, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastian, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamn, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Gurabo, Gyanabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Maras, Las Piedras, Loiza, Luquillo, Manat, Maricao, Maunabo, Mayagez, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincn, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastin, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco Aguada, Aguadilla, Aasco, Cabo Rojo, Canovanas, Carolina, Ceiba, Culebra, Fajardo, Hormigueros, Isabela, Lajas, Las Marias, Loiza, Luquillo, Maricao, Mayaguez, Moca, Rincon, Rio Grande, Sabana Grande, San German, San Juan, San Sebastian, Trujillo Alto, Vieques
Number of Enrollees
8,338
PR
MCS Advantage
Commercial MCO
1915(a)
40,124
PR
MCS Health Management Options, Inc.
Commercial MCO
1915(a)
260,470
Page 59

Commercial MCO
State
PR
Plan
MMM Healthcare Inc.
Operating Authority
1915(a)

Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamn, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Maras, Las Piedras, Lioza, Luquillo, Manat, Maricao, Maunabo, Mayaguz, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincn, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastin, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamn, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Maras, Las Piedras, Lioza, Luquillo, Manat, Maricao, Maunabo, Mayaguz, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincn, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastin, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamon, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Maras, Las Piedras, Loiza, Luquillo, Manat, Maricao, Maunabo, Mayagez, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincn, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastin, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco
Number of Enrollees
48,755
PR
PMC Medicare Choice
Commercial MCO
1915(a)
32,093
PR
Salud Dorada con Medicare
Commercial MCO
1915(a)
3,292
Page 60

Commercial MCO
State
PR
Plan
Triple S
Operating Authority
1915(a)

Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Aasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamn, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catao, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Daz, Juncos, Lajas, Lares, Las Maras, Las Piedras, Lioza, Luquillo, Manat, Maricao, Maunabo, Mayaguz, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Peuelas, Ponce, Quebradillas, Rincn, Ro Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastin, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco Adjuntas, Arecibo, Barceloneta, Bayamn, Camuy, Catao, Ciales, Comero, Corozal, Dorado, Florida, Guanica, Guayanilla, Guaynabo, Hatillo, Jayuya, Lares, Manati, Morovis, Naranjito, Penuelas, Ponce, Quebradillas, Toa Alta, Toa Baja, Utuado, Vega Alta, Vega Baja, Yauco Statewide Statewide Statewide except for Zip Codes Block Island 02807 Statewide Statewide Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkely, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Greenville, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg, York
Number of Enrollees
18,405
PR
Triple-S, Inc.
Commercial MCO
1915(a)
323,026
RI RI RI RI RI SC
Blue Cross & Blue Shield of Rhode Island Neighborhood Health Plan of Rhode Island PACE Organization of Rhode Island United HealthCare Dental - RIte Smiles United HealthCare of New England Absolute Total Care
Commercial MCO Medicaid MCO PACE Dental PAHP Commercial MCO Medicaid MCO
1115 1115 PACE 1115 1115 1915(a)
13,638 74,027 164 41,717 32,578 46,270
Page 61

Medicaid MCO
State
SC
Plan
BlueChoice Health Plan
Operating Authority
1915(a)

Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dorchester, Fairfield, Florence, Greenville, Hampton, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Newberry, Oconee, Orangeburg, Pickens, Richland, Spartanburg, Sumter, Union, Williamsburg, York Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg, York Aiken, Bamberg, Barnwell, Berkley, Calhoun, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dorchester, Edgefield, Fairfield, Kershaw, Lancaster, Lexington, McCormick, Newberry, Orangeburg, Richland, Saluda, Sumter, Union, York Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg, York Region 3, Region 4, Region 5, Region 6 Region 1, Region 2 Anderson, Berkeley, Charleston, Dorchester, Greenville, Lexington, Oconee, Pickens, Richland Lexington, Richland Statewide
Number of Enrollees
19,464
SC
Carolina Crescent Health Plan
Medicaid MCO
1915(a)
33,867
SC
CHCcares of South Carolina
Medicaid MCO
1915(a)
4,254
SC
First Choice by Select Health of South Carolina, Inc.
Medicaid MCO
1915(a)
184,059
SC SC SC SC SC
Logisticare Medical Transportation Management (MTM) Medically Fragile Children Palmetto SeniorCare (PACE) South Carolina Solutions
Transp PAHP Transp PAHP Medical-only PAHP PACE PCCM
1902(a)(70) 1902(a)(70) 1915(a) PACE 1932(a)
508,817 254,408 142 375 90,136
Page 62

PACE Medicaid MCO
State
SC SC
Plan
The Oaks PACE Unison Health Plan of SC
Operating Authority
PACE 1915(a)

Orangeburg County Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Georgetown, Greenville, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Sumter, Union, Williamsburg, York Statewide Hamilton East Tennessee Middle Tennessee West Tennessee Middle Tennessee Statewide Statewide Statewide East Tennessee West Tennessee
Number of Enrollees
32 53,868
SD TN TN TN TN TN TN TN TN TN TN
PRIME Alexian Brothers Community Services AmeriChoice - East TN AmeriChoice - Middle TN AmeriChoice - West TN AmeriGroup Community Care Doral Dental of Tennessee, LLC Premier Behavioral Systems of TN SXC Health Solution Corperation Volunteer State Health Plan (Bluecare) East Volunteer State Health Plan (Bluecare) West
PCCM PACE Medicaid MCO Medicaid MCO Medicaid MCO Medicaid MCO *Dental Benefit Manager MH/SUD PIHP *Pharmacy Benefit Manager Medicaid MCO Medicaid MCO
Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Administrative Services Fee Risk-based Capitation Administrative Services Fee Risk-based Capitation Risk-based Capitation
1932(a) PACE 1115 1115 1115 1115 1115 1115 1115 1115 1115
85,476 309 172,670 189,868 162,647 189,937 678,776 71,661 1,230,750 249,726 194,241
Page 63

*Prepaid Inpatient Health Plan (PIHP), partial risk, partial capitation Commercial MCO Medicaid MCO
State
TN
Plan
Volunteer State Health Plan (TennCare Select)
Partial Capitation
Operating Authority
1115

Statewide
Number of Enrollees
71,661
TX TX
Aetna Amerigroup (STAR)
1915(b) 1915(b)
Atascosa, Bexar, Comal, Denton, Guadalupe, Hood, Johnson, Kendall, Medina, Parker, Tarrant, Wilson, Wise Bastrop, Brazoria, Burnet, Caldwell, Collin, Dallas, Denton, Ellis, Fort Bend, Galveston, Harris, Hays, Hood, Hunt, Johnson, Kaufman, Lee, Montgomery, Navarro, Parker, Rockwell, Tarrant, Travis, Waller, Williamson, Wise Atascosa, Bastrop, Bexar, Blanco, Brazoria, Burnet, Caldwell, Comal, Fort Bend, Galveston, Guadalupe, Harris, Hays, Kendall, Lee, Medina, Montgomery, Travis, Waller, Williamson, Wilson 79901, 79902, 79903, 79904, 79905, 79907, 79915, 79924, 79925, 79930, 79935, 79936 Atascosa, Bexar, Comal, Guadalupe, Kendall, Medina, Wilson Brazoria, Fort Bend, Galveston, Harris, Montgomery, Waller Denton, Hood, Johnson, Parker, Tarrant, Wise Aransas, Bee, Calhoun, Jim Wells, Kleberg, Nueces, Refugio, San Patricio, Victoria El Paso Bastrop, Blanco, Brazoria, Burnet, Caldwell, Crosby, Floyd, Fort Bend, Galveston, Garza, Hale, Harris, Hays, Hockley, Lamb, Lee, Lubbock, Lynn, Montgomery, Terry, Travis, Waller, Williamson Crosby, Floyd, Garza, Hale, Hockley, Lamb, Lubbock, Lynn, Terry 79015, 79101, 79102, 79103, 79104, 79106, 79107, 79108, 79109, 79110, 79111, 79118, 79119, 79121, 79124
38,597 351,524
TX
Amerigroup (STAR+PLUS)
Medicaid MCO
1915(b), 1915(b)/(c)
54,887
TX TX TX TX TX TX TX
Bienvivir Senior Health Service Community First Community Health Choice Cook Children's Driscoll El Paso First Premier Evercare
PACE Commercial MCO Medicaid MCO Medicaid MCO Medicaid MCO Commercial MCO Medicaid MCO
PACE 1915(b) 1915(b) 1915(b) 1915(b) 1915(b) 1915(b), 1915(b)/(c)
761 72,332 98,795 40,990 36,982 39,914 54,488
TX TX
First Care Jan Werner Adult Day Care Center
Commercial MCO PACE
1915(b) PACE
24,937 128
Page 64

Disease Management PAHP Medicaid MCO Medicaid MCO
State
TX
Plan
McKesson Health Solutions
Operating Authority
1915(b)

Statewide
Number of Enrollees
54,794
TX TX
Molina (STAR) Molina (STAR+Plus)
1915(b) 1915(b), 1915(b)/(c) 1915(b) 1932(a)
Brazoria, Fort Bend, Galveston, Harris, Montgomery, Waller Atascosa, Bexar, Brazoria, Comal, Fort Bend, Galveston, Guadalupe, Harris, Kendall, Medinal, Montgomery, Waller, Wilson Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, Rockwall Anderson, Andrews, Angelina, Archer, Armstrong, Austin, Bailey, Bandera, Baylor, Bell, Bordon, Bosque, Bowie, Brazos, Brewster, Briscoe, Brooks, Brown, Burleson, Callahan, Cameron, Camp, Carson, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Coke, Coleman, Collingsworth, Colorado, Comanche, Concho, Cooke, Coryell, Cottle, Crane, Crockett, Dallam, Dawson, Deaf Smith, Delta, DeWitt, Dickens, Dimmit, Donley, Duval, Eastland, Ector, Edwards, Erath, Falls, Fannin, Fayette, Fisher, Foard, Franklin, Freestone, Frio, Gaines, Gillespie, Glasscock, Goliad, Gonzales, Gray, Grayson, Gregg, Grimes, Hall, Hamilton, Hansford, Hardeman, Hardin, Harrison, Hartley, Haskell, Hemphill, Henderson, Hildalgo, Hill, Hopkins, Houston, Howard, Hutchinson, Irion, Jack, Jackson, Jasper, Jeff Davis, Jefferson, Jim Hogg, Jones, Karnes, Kenedy, Kent, Kerr, Kimble, King, Kinney, Knox, La Salle, Lamar, Lampasas, Lavaca, Leon, Liberty, Limestone, Lipscomb, Live Oak, Llano, Loving, Madison, Marion, Martin, Mason, Matagorda, Maverick, McCulloch, McLennan, McMullen, Menard, Midland, Milam, Mills, Mitchell, Montague, Moore, Morris, Motley, Nacogdoches, Newton, Nolan, Ochiltree, Oldham, Orange, Palo Pinto, Panola, Parmer, Pecos, Polk, Potter, Presidio, Rains, Randall, Reagan, Real, Red River, Reeves, Roberts, Robertson, Runnels, Sabine, San Augustine, San Jacinto, San Saba, Schleicher, Scurry, Shackelford, Shelby, Sherman, Smith, Somervell, Starr, Stephens, Sterling, Stonewall, Sutton, Swisher, Taylor, Terrell, Throckmorton, Titus, Tom Green, Trinity, Tyler, Upshur, Upton, Uvalde, Val Verde, Van Zandt, Walker, Ward, Washington, Webb, Wharton, Wheeler, Wichita, Wilbarger, Willacy, Winkler, Wood, Yoakum, Young, Zapata, Zavala
10,145 17,079
TX TX
Parkland Community Health Plan PCCM
Medicaid MCO PCCM
122,684 732,219
Page 65

Medicaid MCO Medicaid MCO
State
TX TX
Plan
Superior HealthPlan (STAR Health) Superior HealthPlan (STAR)
Operating Authority
1915(a) 1915(b)

Statewide Atascosa, Bastrop, Bexar, Burnet, Caldwell, Comal, Crosby, El Paso, Floyd, Garza, Guadalupe, Hale, Hays, Hockley, Hudspeth, Kendall, Lamb, Lee, Lubbock, Lynn, Medina, Terry, Travis, Williamson, Wilson Aransas, Atascosa, Bee, Bexar, Calhoun, Comal, Guadalupe, Jim Wells, Kendall, Kleberg, Medina, Nueces, Refugio, San Patricio, Victoria, Wilson Brazoria, Fort Bend, Galveston, Harris, Montgomery, Waller Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, Rockwall Brazoria, Fort Bend, Galveston, Harris, Montgomery, Waller Collin County, Dallas County, Ellis County, Hunt County, Kaufman County, Navarro County, Rockwall County Box Elder, Cache, Rich Juab, Millard, Piute, Sanpete, Sevier, Wayne Davis Carbon, Emery, Grand Davis County, Salt Lake County, Utah County, Weber County Davis, Salt Lake, Utah, Weber Statewide Daggett, Duchesne, Uintah
Number of Enrollees
29,508 211,806
TX
Superior HealthPlan (STAR+Plus)
Medicaid MCO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation FFS/Some Risk Based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Non-risk Capitation Non-risk Capitation Risk-based Capitation Risk-based Capitation
1915(b), 1915(b)/(c) 1915(b) 1915(b) 1915(b) 1915(b) 1115, 1915(b) 1115, 1915(b) 1115, 1915(b) 1115, 1915(b) 1115, 1915(b) 1115, 1915(b) 1915(b) 1115, 1915(b)
35,680
TX TX TX TX UT UT UT UT UT UT UT UT
Texas Children's Health Plan Unicare United ValueOptions Bear River Mental Health Central Utah Counseling Center Davis Behavioral Health Four Corners Community Behavioral Health Healthy U Molina Healthcare of Utah (Molina) Non-Emergency Medical Transportation Northeastern Counseling Center
Medicaid MCO Commercial MCO Commercial MCO MH/SUD PIHP Mental Health PIHP Mental Health PIHP Mental Health PIHP Mental Health PIHP Medical-only PIHP Medical-only PIHP Transp PAHP Mental Health PIHP
153,468 23,699 10,587 306,513 12,284 7,115 16,430 4,544 29,338 42,116 176,036 4,207
Page 66

PCCM Mental Health PIHP Mental Health PIHP Mental Health PIHP Mental Health PIHP PACE Medicaid MCO
State
UT UT UT UT UT VA VA
Plan
Select Access Southwest Behavioral Health Services Valley Mental Health Wasatch Mental Health Weber Human Services AllCare for Seniors AmeriGroup Community Care
Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1115, 1915(b) 1115, 1915(b) 1115, 1915(b) 1115, 1915(b) 1115, 1915(b) PACE 1915(b)

Davis County, Salt Lake County, Utah County, Weber County Beaver, Garfield, Iron, Kane, Washington Salt Lake, Summit, Tooele Utah County Morgan, Weber Buchanan, Dickerson, Russell, Tazewell Alexandria City, Arlington County, Fairfax City, Fairfax County, Falls Church City, Fauquier County, Loudoun County, Manassas City, Manassas Park City, Prince William County Accomack County, Albemarle County, Alexandria City, Amelia County, Arlington County, Brunswick County, Buckingham County, Caroline County, Charles City County, Charlottesville City, Chesapeake City, Chesterfield County, Clarke County, Colonial Heights City, Cumberland County, Dinwiddie County, Emporia City, Essex County, Fairfax City, Fairfax County, Falls Church City, Fauquier County, Fluvanna County, Franklin City, Frederick County, Fredericksburg City, Gloucester County, Goochland County, Greene County, Greensville County, Halifax County, Hampton City, Hanover County, Henrico County, Hopewell City, Isle of Wight County, James City County, King and Queen County, King George County, King William County, Lancaster County, Loudoun County, Louisa County, Lunenburg County, Madison County, Manassas City, Manassas Park City, Mathews County, Mecklenburg County, Middlesex County, Nelson County, New Kent County, Newport News City, Norfolk City, Northampton County, Northumberland County, Nottoway County, Orange County, Petersburg City, Poquoson City, Portsmouth City, Powhatan County, Prince Edward County, Prince George County, Prince William County, Richmond City, Richmond County, Southampton County, Spotsylvania County, Stafford County, Suffolk City, Surry County, Sussex County, Virginia Beach City, Warren County, Westmoreland County, Williamsburg City, Winchester City, York County
Number of Enrollees
58,484 18,006 83,812 34,822 20,342 27 24,889
VA
Anthem Healthkeepers Plus
Commercial MCO
1915(b)
163,028
Page 67

Transp PAHP PCCM
State
VA VA
Plan
LogistiCare Solutions MEDALLION
Risk-based Capitation Fee-For-Service
Operating Authority
1902(a)(70) 1915(b)

Statewide Alleghany County, Bath County, Bland County, Bristol City, Buchanan County, Carroll County, Covington City, Craig County, Dickenson County, Galax, Grayson County, Highland County, Lee County, Norton, Russell, Scott County, Smyth County, Tazewell County, Washington County, Wise County Lee, Norton, Scott, Wise Accomack County, Albemarle County, Amelia County, Amherst County, Appomattox County, Augusta County, Brunswick County, Buckingham County, Campbell County, Caroline County, Charles City County, Charlotte County, Charlottesville City, Chesapeake City, Chesterfield County, Clarke County, Colonial Heights City, Cumberland County, Danville City, Dinwiddie County, Emporia City, Essex County, Fluvanna County, Franklin City, Frederick County, Gloucester County, Goochland County, Greene County, Greensville County, Halifax County, Hampton City, Hanover County, Harrisonburg City, Henrico County, Hopewell City, Isle of Wight County, James City County, King and Queen County, King William County, Lancaster County, Louisa County, Lunenburg County, Madison County, Mathews County, Mecklenburg County, Middlesex County, Nelson County, New Kent County, Newport News City, Norfolk City, Northampton County, Northumberland County, Nottoway County, Orange County, Page County, Petersburg City, Pittsylvania County, Poquoson City, Portsmouth City, Powhatan County, Prince Edward County, Prince George County, Rappahannock County, Richmond City, Richmond County, Rockingham County, Shenandoah County, Southampton County, Staunton City, Suffolk City, Surry County, Sussex County, Virginia Beach City, Warren County, Waynesboro City, Westmoreland County, Williamsburg City, Winchester City, York County Hampton, Newport News, Poquoson, Southeastern portion of York County Chesapeake, Norfolk, Portsmouth, Virginia Beach
Number of Enrollees
520,773 54,101
VA VA
Mountain Empire Optima Family Care
PACE Commercial MCO
PACE 1915(b)
48 130,954
VA VA
Riverside Peninsula Sentara Senior Community Care
PACE PACE
PACE PACE
114 126
Page 68

Commercial MCO
State
VA
Plan
Southern Health CareNet
Operating Authority
1915(b)

Albemarle County, Amelia County, Amherst County, Appomattox County, Augusta County, Buckingham County, Campbell County, Caroline County, Charles City County, Charlottesville, Chesterfield County, Colonial Heights City, Cumberland County, Dinwiddie County, Essex County, Fluvanna County, Goochland County, Greene County, Hanover County, Henrico County, Hopewell City, King and Queen County, King William County, Lancaster County, Louisa County, Lunenburg County, Lynchburg, Mathews County, Mecklenburg County, Middlesex County, Nelson County, New Kent County, Northumberland County, Nottoway County, Orange County, Petersburg City, Powhatan County, Prince George County, Richmond City, Richmond County, Staunton, Surry County, Sussex County, Waynesboro, Westmoreland County Accomack County, Albemarle County, Amelia County, Appomattox County, Augusta County, Bedford City, Bedford County, Botetourt County, Brunswick County, Buckingham County, Buena Vista City, Campbell County, Caroline County, Charles City County, Charlotte County, Charlottesville City, Chesapeake City, Chesterfield County, Clarke County, Colonial Heights City, Culpeper County, Cumberland County, Danville, Dinwiddie County, Emporia City, Floyd County, Fluvanna County, Franklin City, Franklin County, Frederick County, Fredericksburg City, Giles County, Goochland County, Greene County, Greensville County, Halifax County, Hampton City, Hanover County, Harrisonburg City, Henrico County, Henry County, Hopewell City, King George County, King William County, Lexington City, Louisa County, Lunenburg County, Lynchburg City, Madison County, Martinsville City, Mecklenburg County, Montgomery County, Nelson County, New Kent County, Newport News City, Norfolk City, Northampton County, Nottoway County, Orange County, Page County, Patrick County, Petersburg City, Pittsylvania County, Portsmouth City, Powhatan County, Prince Edward County, Prince George County, Pulaski County, Radford City, Rappahannock County, Richmond City, Roanoke City, Roanoke County, Rockbridge County, Rockingham County, Salem City, Shenandoah County, Southampton County, Spotsylvania County, Stafford County, Staunton City, Suffolk City, Surry County, Sussex County, Virginia Beach City, Warren County, Waynesboro City, Westmoreland County, Winchester City, Wythe County Statewide
Number of Enrollees
18,896
VA
Virginia Premier Health Plan
Medicaid MCO
1915(b)
128,905
VT
Global Committment to Health
Medicaid MCO
1115
137,385
Page 69

PACE Commercial MCO Disease Management PAHP Commercial MCO Commercial MCO
State
VT WA WA
Plan
Vermont PACE Asuris Northwest Health City of Seattle Human Services
Operating Authority
PACE 1932(a) 1932(a)

Chittereden, Dorset, Grand Isle, Manchester, Rupert, South Hero Spokane County King
Number of Enrollees
76 2,003 8,386
WA WA
Columbia United Providers Community Health Plan
1932(a) 1932(a)
Clark Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Ferry, Franklin, Grant, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Oriellle, Pierce, San Juan, Skagit, Skamania, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Yakima King, Kitsap, Pierce, Snohomish, Spokane, Thurston Clark, Cowlitz Adams, Asotin, Benton, Chelan, Clallam, Clark, Columbia, Cowlitz, Douglas, Ferry, Franklin, Garfield, Grant, Grays Harbor, King, Kitsap, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Orielle, Pierce, San Juan, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Whatcom, Whitman, Yakima Snohomish Statewide King Clallam, Grays Harbor, Island, Pacific, Pierce, San Juan, Skagit, Snohomish, Yakima Statewide
37,848 189,559
WA WA WA
Group Health Cooperative Kaiser Foundation Health Plan Molina Healthcare
Commercial MCO Commercial MCO Commercial MCO
1932(a) 1932(a) 1932(a)
20,656 876 291,562
WA WA WA WA WA
Molina Healthcare (WMIP) PCCM Tribal Clinics Providence ElderPlace - Seattle Regence Blue Shield Regional Support Network
Commercial MCO PCCM PACE Commercial MCO Mental Health PIHP
Risk-based Capitation Fee-For-Service Risk-based Capitation Risk-based Capitation Risk-based Capitation
1932(a) 1932(a) PACE 1932(a) 1915(b)
2,990 4,495 319 36,093 949,263
Page 70

Commercial MCO
State
WI
Plan
Abri Health Plan -- Medicaid HMO
Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation Risk-based Capitation
Operating Authority
1932(a)

Brown, Dodge, Jefferson, Kenosha, Kewaunee, Milwaukee, Outagamie, Ozaukee, Racine, Washington, Waukesha, Waupace, Winnebago Brown, Dodge, Jefferson, Kenosha, Kewaunee, Milwaukee, Outagamie, Ozaukee, Racine, Washington, Waukesha, Waupace, Winnebago Columbia, Dodge, Green Lake, Jefferson, Marquette, Washington, Waukesha, Waushara Dane County Columbia, Dane, Iowa, Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington, Waukesha Chippewa, Dunn, Eau Claire, Pierce, St. Croix Milwaukee Marathon, Portage, Wood Milwaukee Calumet, Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Walworth, Washington, Waukesha Chippewa, Dunn, Eau Claire Adams, Ashland, Barron, Bayfield, Buffalo, Burnett, Chippewa, Crawford, Douglas, Dunn, Eau Claire, Grant, Green, Jackson, Juneau, La Crosse, Marquette, Monroe, Pepin, Pierce, Polk, Richland, Rusk, Sauk, Sawyer, St. Croix, Trempealeau, Vernon, Washburn Dane Columbia, Dane, Dodge, Grant, Green, Jefferson, Kenosha, Milwaukee, Ozaukee, Racine, Rock, Sauk, Walworth, Waukesha
Number of Enrollees
14,403
WI
Abri Health Plan -- SSI
Commercial MCO
1932(a)
1,783
WI WI WI WI WI WI WI WI WI WI
Care Wisconsin First, Inc. Care Wisconsin Health Plan, Inc. (Partnership) Children's Community Health Plan Medicaid HMO CHP-LTS, Inc. Community Care Health Plan, Inc. Community Care of Central Wisconsin Community Care Organization (PACE) Community Care, Inc. Community Health Partnership -Partnership Compcare -- Medicaid HMO
Long Term Care PIHP Medicaid MCO Commercial MCO Long Term Care PIHP Commercial MCO Long Term Care PIHP PACE Long Term Care PIHP Commercial MCO Commercial MCO
1915(b)/(c) 1932(a)/1915(c) 1932(a) 1915(b)/(c) 1932(a)/1915(c) 1915(b)/(c) PACE 1915(b)/(c) 1932(a) 1932(a)
2,774 1,115 21,705 922 1,147 6,122 577 3,803 935 29,955
WI WI
Dane County Human Services Department -- CCF Dean Health Plan -- Medicaid HMO
MH/SUD PIHP Commercial MCO
1915(a) 1932(a)
134 41,704
Page 71

Commercial MCO
State
WI
Plan
Group Health Cooperative Of Eau Claire -- Medicaid HMO
Operating Authority
1932(a)

Ashland, Barron, Bayfield, Buffalo, Burnett, Chippewa, Clark, Columbia, Crawford, Douglas, Dunn, Eau Claire, Grant, Green, Iowa, Jackson, Juneau, Lafayette, Lincoln, Marathon, Pepin, Pierce, Polk, Price, Rusk, Sauk, Sawyer, St. Croix, Taylor, Trempealeau, Washburn Buffalo, Jackson, La Crosse, Monroe, Trempealeau, Vernon Dane, Monroe, Vernon Buffalo, Crawford, Grant, Jackson, Juneau, La Crosse, Monroe, Trempealeau, Vernon Buffalo, Crawford, Grant, La Crosse, Monroe, Trempealeau, Vernon Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha Fond du Lac Brown, Calumet, Clark, Dodge, Fond du lac, Green Lake, Jefferson, Kenosha, Langlade, Manitowoc, Marathon, Marquette, Menominee, Milwaukee, Oconto, Oneida, Outagamie, Ozaukee, Portage, Racine, Rock, Shawano, Sheboygan, Taylor, Vilas, Walworth, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood Kensosha, Milwaukee, Racine, Waukesha Dane, Green, Jefferson, Rock, Walworth Milwaukee Milwaukee
Number of Enrollees
30,529
WI WI WI WI WI WI WI WI
Group Health Cooperative of Eau Claire County SSI Group Health Cooperative Of South Central WI -- Medicaid HMO Gundersen Lutheran Health Plan Medicaid HMO Health Tradition Health Plan -- Medicaid HMO Independent Care (iCare) - Medicaid HMO Independent Care Health Plan -- SSI Lakeland Care District Managed Health Services -- Medicaid HMO
Commercial MCO Commercial MCO Commercial MCO Commercial MCO Medicaid MCO Medicaid MCO Long Term Care PIHP Medicaid MCO
1932(a) 1932(a) 1932(a) 1932(a) 1932(a) 1932(a) 1915(b)/(c) 1932(a)
760 3,867 13,317 8,069 5,200 8,372 1,040 76,347
WI WI WI WI
Managed Health Services -- SSI MercyCare Insurance Company -Medicaid HMO Milwaukee County Department on Aging Milwaukee County Human Services Department -- Wraparound Milwaukee
Medicaid MCO Commercial MCO Long Term Care PIHP MH/SUD PIHP
1932(a) 1932(a) 1915(b)/(c) 1915(a)
4,751 13,309 6,796 771
Page 72

Commercial MCO
State
WI
Plan
Network Health Plan -- Medicaid HMO
Operating Authority
1932(a)

Brown, Calumet, Clark, Dodge, Fond du lac, Forest, Green Lake, Jefferson, Kenosha, Langlade, Lincoln, Manitowoc, Marathon, Marquette, Menominee, Milwaukee, Oconto, Oneida, Outagamie, Ozaukee, Portage, Racine, Rock, Shawano, Sheboygan, Taylor, Vilas, Walworth, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood Kenosha, Milwaukee, Racine, Waukesha Ashland, Barron, Bayfield, Burnett, Douglas, Iron, Polk, Price, Rusk, Sawyer, Washburn Chippewa, Dunn, Eau Claire Dane Adams, Ashland, Barron, Chippewa, Clark, Eau Claire, Forest, Iron, Jackson, Juneau, Langlade, Lincoln, Marathon, Oneida, Polk, Portage, Price, Rusk, Sawyer, Shawano, Taylor, Vilas, Washburn, Waupaca, Wood Crawford, Green, Juneau, Lafayette, Richland, Sauk Ashland, Bayfield, Brown, Burnett, Calumet, Dodge, Douglas, Fond du Lac, Green Lake, Jefferson, Kenosha, Kewaunee, Langlade, Manitowoc, Marathon, Marquette, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Polk, Portage, Racine, Rock, Shawano, Sheboygan, Walworth, Washburn, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood Ashland, Bayfield, Brown, Burnett, Calumet, Dodge, Douglas, Fond du lac, Green Lake, Jefferson, Kenosha, Kewaunee, Langlade, Manitowoc, Marathon, Marquette, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Polk, Portage, Racine, Rock, Shawano, Sheboygan, Taylor, Walworth, Washburn, Washington, Waukesha, Waupace, Waushara, Winnebago, Wood Columbia, Dane, Dodge, Green, Jefferson, Sauk Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, Vernon
Number of Enrollees
47,302
WI WI WI WI WI
Network Health Plan - SSI Northern Bridges Partnership Health Plan, Inc. Physicians Plus Health Plan - Medicaid HMO Security Health Plan -- Medicaid HMO
Commercial MCO Long Term Care PIHP Commercial MCO Commercial MCO Commercial MCO
1932(a) 1915(b)/(c) 1932(a)/1915(c) 1932(a) 1932(a)
2,657 870 1,884 4,573 40,823
WI WI
Southwest Family Care Alliance UnitedHealthcare of WI -- Medicaid HMO
Long Term Care PIHP Commercial MCO
1915(b)/(c) 1932(a)
917 187,573
WI
UnitedHealthcare of WI -- SSI
Commercial MCO
1932(a)
7,346
WI WI
Unity Health Insurance -- Medicaid HMO Western Wisconsin Cares
Commercial MCO Long Term Care PIHP
1932(a) 1915(b)/(c)
11,130 3,067
Page 73

Commercial MCO
State
WV
Plan
Carelink Health Plan
Operating Authority
1915(b), 1937

Boone, Brooke, Clay, Fayette, Hancock, Jackson, Kanawha, Lincoln, Logan, Marshall, Mingo, Nicholas, Ohio, Pleasants, Putnam, Raleigh, Tyler, Webster, Wetzel, Wirt, Wood Barbour, Brooke, Doddridge, Gilmer, Hancock, Harrison, Lewis, Marion, Marshall, Monongalia, Ohio, Pleasants, Preston, Randolph, Ritchie, Taylor, Tucker, Tyler, Upshur, Wetzel, Wirt, Wood Statewide Barbour, Berkeley, Boone, Braxton, Calhoun, Clay, Doddridge, Fayette, Gilmer, Greenbrier, Hampshire, Harrison, Jackson, Jefferson, Kanawha, Lewis, Lincoln, Logan, Marion, Marshall, McDowell, Mercer, Mineral, Mingo, Monongalia, Monroe, Morgan, Nicholas, Ohio, Pleasants, Pocahontas, Preston, Putnam, Raleigh, Randolph, Ritchie, Roane, Summers, Taylor, Tucker, Tyler, Upshur, Webster, Wetzel, Wirt, Wood, Wyoming
Number of Enrollees
45,168
WV
Health Plan of the Upper Ohio Valley
Commercial MCO
1915(b), 1937
29,142
WV WV
Physician Assured Access System Unicare Health Plan of WV
PCCM Commercial MCO
Fee-For-Service Risk-based Capitation
1915(b) 1915(b), 1937
14,747 75,384
TOTAL NUMBER OF ENROLLEES:
50,224,705
Page 74
2009 ENROLLMENT FACTS SHEET (MAJOR CHANGES FROM 6/30/2008 6/30/2009) Arizona The State Medicaid Enrollment increase was due to the economy. Bridgeway2 is now providing family planning services for the SOBRA family planning population. Georgia The State Medicaid Enrollment increase was due to the economy. Hawaii APS BHS, Child &Adolescent Mental Health Division, Department, and Early Intervention Programs, Department of Health are no longer valid mental PHIP plans under the Hawaii Quest Expanded (QEx) due to the removal of their mental health carve-out portion of their Hawaii Quest Expanded (QEx). The mental health portion is now under the fee-for-service model. Massachusetts - The State Medicaid Enrollment increase was due to the economy and the unemployment rate. Michigan North Country CMH6 is now Northern Affiliation6. Mississippi Due to the inclusion of the 1902(a)(70) NEMT program, the State has managed care enrollment. Missouri Mercy Care Plus2 is now Molina Healthcare of Missouri2. The State Medicaid Managed Care Enrollment is higher than normal due to the inclusion of the 1902(a)(70) NEMT program. Nebraska Mercy Care Plus plan2 is now Molina Healthcare of Missouri2. New Jersey The State Medicaid Enrollment increase was due to the economy and unemployment rate. New York The 1115 Expansion Enrollment decrease was due to the State aligning the Medicaid Resource Level to the Family Health Plus (FHP) Level from $3,000 to $13,000. The State Medicaid Enrollment increase was due to the economy. Care Plus Health Plan2 is now AmeriGroup2. CarePlus Connections14 is now AmeriGroup Community Connections14. Suffolk Health Plan2 was bought out by Neighborhood Health Providers2. North Carolina The State Medicaid Enrollment and State Medicaid Managed Care Enrollment increases were due to statewide outreach efforts, the economy, and the inclusion of the CHIP Expansion enrollment. Ohio The State Medicaid Enrollment increase was due to economy and the unemployment rate. Buckeye Community Health Plan1, CareSource1, Molina Healthcare of Ohio1, Unison Health Plans of Ohio1, and WellCare of Ohio1 were defined as Medicaid MCO but changed their status to Commercial MCO. Pennsylvania The total transportation enrollment for Logisticare Solutions, LLC11 of 34,978 for 2008 reporting period was incorrectly. Rhode Island Neighborhood Health Plan of Rhode Island2 was operating under 1115(a) and 1915(a) authorities but its currently only operating under 1115(a). South Carolina Total Carolina Care Inc.2 is now Absolute Total Care2. Amerigroup Community Care2 merged with Absolute Total Care2. Logisticare and MTM are the two transportation brokers under the 1902(a)(70). The State was unable to accurately separate the number of enrollees in Logisticare and MTM ; therefore, the total number of enrollees of 683,966 were divided with 2/3 in LogistiCare and 1/3 in MTM. 75
2009 ENROLLMENT FACTS SHEET (MAJOR CHANGES FROM 6/30/2008 6/30/2009)
South Dakota The South Dakota Dental Program does not operate under any waiver authority or managed care entity type. This program solely operates under the authority of the South Dakota State Plan. At the States request, it will no longer be reported in this report. Tennessee Volunteer State Health Plan (BlueCare)1 was divided into 2 separate regions Volunteer State Health Plan (BlueCare)2 East and Volunteer State Health Plan (BlueCare)2 West. AmeriGroup Community Care2, Volunteer State Health Plan (Bluecare) East2, Volunteer State Health Plan (Bluecare) West2 were defined as Commercial-only MCO but changed their status to Medicaid-only MCO. TennCare Select4 is now Volunteer State Health Plan (TennCare Select)4. For reporting purposes, TennCare Select plan enrollment is incorporated under the Medical-only PIHP category. Texas The State Medicaid Enrollment increase was due partly to the Womens Health Program and normal growth.
___________________________ Commercial MCO 2 Medicaid-only MCO 3 PCCM 4 Medical-only PIHP 5 Medical-only PAHP 6 Mental Health PIHP 7Mental Health PAHP 8 Dental PAHP 9 PACE 10 Disease Management PAHP 11Transportation PAHP 12 Other 13MH/SUD PIHP 14 Long-Term-Care PIHP
1
76
NEW MEDICAID MANAGED CARE PLANS AS OF 6/30/2009 Arkansas Total Life Healthcare9 is a new PACE organization. California Life Circles9 and Comprehensive Senior Care Corporation9 are new PACE organizations. Colorado Rocky Mountain PACE9 and VOANS PACE9 are new PACE organizations. District of Columbia Medical Transportation Management11 is a new transportation PAHP under the Non-Emergency Medical Transportation Program. Florida Prestige Health Choice2 and Molina Health Care of Florida2 are new MCO plans under the Managed Health Care program. Alternative Medicine Integration10, CareMark10, and Hemophilia of the Sunshine State10 are new Disease Management PAHP plans under the Managed Health Care program. Managed Care of North America8 is a new Dental PAHP under the Managed Health Care Program. Molina Health Care of Florida (Reform)1 is a new plan under Florida Medicaid Reform program. Hawaii Maui PACE9 is a new PACE organization. Evercare1 and Ohana1 are new MCO plans. Illinois - Meridian Health Plan2 is a new MCO plan under the Voluntary Managed Care program. Iowa Sioux PACE9 is a new PACE organization. Maryland AMERIGROUP-PAC5 and Priority Partners PAC5 are new medical-only PAHP plans under the HealthChoice program. Michigan Health Kids Dental8 is a new Dental PAHP plan under Healthy Kids Dental program. Montana Billings Clinic 9is a new PACE organization. Nevada Amerigroup Community Care2 is a new MCO plan under the Mandatory Health Maintenance Program. New Jersey LIFE St. Francis9 and LIFE at Lourdes9 are new PACE organizations. New Mexico AMERIGROUP Community Care of New Mexico, Inc.1 and Evercare of New Mexico1 are new MCO plans under the Coordinated Long-term Care Services program. Blue Cross Blue Shield of New Mexico1 is a new MCO plan under the NEW MEXICO SALUD! program. New York Senior Whole Health/Medicaid Advantage Plus14 is a new LTC PIHP under the F-SHRP Medicaid Advantage program. Total Senior Care9 is a new PACE Organization. Health Plus2 is a new MCO plan under the Federal-State Health Reform Partnership (F-SHRP) program. NYPS Catholic Health Plan 11991 is a new MCO plan under the Partnership Plan Medicaid Managed Care Program. North Dakota Northland PACE9 is a new PACE organization. North Carolina Piedmont Senior Care9 and Elderhaus9 are new PACE organizations. Oklahoma Cherokee Elder Care9 is a new PACE organization. 77
NEW MEDICAID MANAGED CARE PLANS AS OF 6/30/2009
Tennessee SXC Health Solutions12 is a new plan under TennCare program. Volunteer State Health Plan (Bluecare) was broken into regions AmeriChoice West TN2 and Volunteer State Health Plan (Bluecare) East2 are new plans under TennCare program.
Wisconsin Gundersen Lutheran Health Plan1 and Physicians Plus Health Plan1 are new MCO plans under the BadgerCare Plus program. Care Wisconsin First, Inc.14, CHP-LTS, Inc., Community Care of Central Wisconsin14, Community Care, Inc.14, Lakeland Care District14, Milwaukee County Dept. on Aging14, Northern Bridges14, Southern Family Care Alliance14, and Western Wisconsin Cares14 are new Long Term Care PIHP plans under the Family Care program. Partnership Health Plan Inc.1 is a new MCO plan under the Wisconsin Partnership Program. ___________________________ 1 Commercial MCO 2 Medicaid-only MCO 3 PCCM 4 Medical-only PIHP 5 Medical-only PAHP 6 Mental Health PIHP 7 Mental Health PAHP 8 Dental PAHP 9 PACE 10 Disease Management PAHP 11 Transportation PAHP 12 Other 13 MH/SUD PIHP 14 Long-Term Care PIHP
78
TERMINATED MEDICAID MANAGED CARE PLANS AS OF 6/30/2009 Florida Pediatric Associates (Reform)4 terminated under the Florida Medicaid Reform program. Vista Health Plan of South Florida1, Community Based Care Partnership6, and Buena Vista1 were terminated under the Managed Health Care program. StayWell (Reform)1 was terminated under the Florida Medicaid Reform program. Hawaii Summerlin1 was terminated under the Hawaii Quest Expanded (QEx) program. Iowa Coventry HealthCare1 plan was terminated under the Iowa Medicaid Managed Care program. Nevada Anthem Blue Cross Blue Shield Partnership1 plan was terminated under the Mandatory Health Maintenance program. New York - Manhattan PHSP/CenterCare2, NY Presbyterian Hospital Health Plan1, and Preferred Care1 were terminated under the Federal-State Health Reform Partnership (FSHRP), Partnership-Family Health Plus, and Partnership Plan Medicaid Managed Care Program. Ohio Anthem Blue Cross Blue Shield Partnership Plan2 was terminated under the State Plan Amendment for Ohio's Full-Risk Managed Care Program. Puerto Rico COSVIMed1 and MAPFRE1 were terminated under the Medicare Platino program. Tennessee First Health Services Corporation12, Preferred health Partnership/PHP2, TLC Family Healthplan2, Unison Health Plan-BHHP1, UAHC Health Plan of Tennessee2, Inc, Tennessee Behavioral Health13 plans were terminated under the TennCare program. Texas - Evercare of Texas2 was terminated under ICM program.
Washington United Healthcare Services Inc.10 was terminated under the Chronic Care Management Program (CCMP). ___________________________ 1 Commercial MCO 2 Medicaid-only MCO 3 PCCM 4 Medical-only PIHP 5 Medical-only PAHP 6 Mental Health PIHP 7Mental Health PAHP 8 Dental PAHP 9 PACE 10Disease Management PAHP 11Transportation PAHP 12 Other 13MH/SUD PIHP 14 Long-Term Care PIHP
79
Medicaid Managed Care Enrollment Report Glossary as of June 30, 2009

Terms used in "Managed Care Entity" column
Primary Care Case Management (PCCM) Provider is a provider (usually a physician, physician group practice, or an entity employing or having other arrangements with such physicians, but sometimes with such physicians, but sometimes also including nurse practitioners, nurse midwives, or physician assistants who contracts directly with the State to locate, coordinate, and monitor covered primary care (and sometimes additional services). This category also includes those PIHPs that contract with the State as primary care case managers. Commercial Managed Care Organization (MCO) A Commercial MCO is a health maintenance organization, an eligible organization with a contract under 1876 or a Medicare+Choice organization, a provider sponsored organization or any other private or public organization, which meets the requirements of 1902(w). A Commercial MCO provides comprehensive services to both Medicaid and commercial and/or Medicare. Medicaid-only Managed Care Organization (MCO) A Medicaid-only MCO provides comprehensive services to only Medicaid beneficiaries, not to commercial or Medicare enrollees. Health Insuring Organization (HIO) A HIO is a managed care entity which, by law, is exempt from certain rules governing MCO program operation such as the requirement for beneficiaries to have a choice of at least two managed care entities in mandatory programs. Prepaid Inpatient Health Plan (PIHP) A PIHP is a prepaid inpatient health plan that provides less than comprehensive services on an at-risk or other than state plan reimbursement basis; and provides, arranges for, or otherwise has responsibility for the provision of any inpatient hospital or institutional services. {Comprehensive services are define in 42 CFR 438.2} There are several types of PIHPs that States use to deliver a range of services. For example, a Mental Health (MH) PIHP is a managed care entity that provides only mental health services. Prepaid Ambulatory Health Plan (PAHP) A PAHP is a prepaid ambulatory health plan that provides less than comprehensive services on an at-risk or other than state plan reimbursement basis, and does not provide, arrange for, or otherwise have responsibility for the provision of any inpatient hospital or institutional services. {Comprehensive services are defined in 42 CFR 438.2} There are several types of PAHPs that States use to deliver a range of services. For example, a Dental PAHP is a managed care entity that provides only dental services. Program for All-inclusive Care for the Elderly (PACE) program that provides prepaid, capitated comprehensive, health care services to the frail elderly. Other The structure of the managed care plan is not considered a PCCM, PIHP, PAHP, Commercial MCO, Medicaid-only MCO, HIO, or PACE.
80
Terms used in "Reimbursement Arrangement" Column

Risk-based Capitation The managed care entity is paid for providing services to enrollees primarily through capitation. (There may be other payments under the contract such as incentive arrangements or risk sharing.) Non-risk Capitation The managed care entity is paid for providing services to enrollees through capitation, but payments are settled at the end of the year at amounts that do not exceed the FFS cost for services actually provided, plus an amount for administration. Fee-For-Service (FFS) The managed care entity is paid for providing services to enrollees solely through fee-for service payments plus in most cases, a case management fee. Other The managed care entity is providing services to enrollees through means other than through capitation or fee-for-service reimbursements.
81

CMS Enrollment Report

Загружено:

Сведения о документе

Исходное описание:

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

CMS Enrollment Report

Загружено:

Авторское право:

Доступные форматы

2009 MEDICAID MANAGED CARE ENROLLMENT REPORT SUMMARY STATISTICS AS OF JUNE 30, 2009

Medicaid Managed Care Enrollment Report as of June 30, 2009

MANAGED CARE TRENDS

4 159 159 36 152 60 67 9 646

601,662 10,284,082 13,176,581 7,275,241 8,593,773 7,866,947 17,091 2,113,534 49,928,911

NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

Percent of Total Medicaid Population

Other Managed Care

NATIONAL SUMMARY OF MEDICAID MANAGED CARE PROGRAMS AND ENROLLMENT

Total Medicaid Population (in millions)

13.72 16.82 15.82 16.50

Other Managed Care

0.00 2004 2005 2006 2007

* Note: Numbers may not add up to totals due to rounding.

NUMBER OF MANAGED CARE ENTITIES BY STATE AS OF JUNE 30, 2009 STATE

MEDICAID MANAGED CARE ENROLLMENT AS OF 6/30/09

Disease Management Enrollees

Medical-only Enrollees 540,093

1 1 1 1 6 15,157 3,593 115,980 5 569,329 1 1 18 1 1,447,373 312,498 5 157 448,307

15 329,897 1 304,821 243,352

DUAL ELIGIBLE ENROLLMENT AS OF JUNE 30, 2009 Medicaid Dual Eligibles

MANAGED CARE ENTITY TYPES MCO PCCM PIHP

12,557 153 49,553

30,569 2,581 216,417 187,246 86,354 14,832 519 9,958 893,649

905 626 8,337 4,621

52,344 188,192 33,498 11,056 1,017 20,789 97,637 36,316 610,552

Medicaid Managed Care Program Summary

Geographic Area Served

1115 1115 1115 1115 1115 1115 1115 1115 1115

604 220,485 56 16,182 2,405 49,355 208 938 0

Medicaid Managed Care Program Summary

Geographic Area Served

Medicaid Managed Care Program Summary

Geographic Area Served

Medicaid Managed Care Program Summary

Geographic Area Served

Medicaid Managed Care Program Summary

Geographic Area Served

1915(b), 1932(a) 1915(b)

San Francisco Santa Barbara

Medicaid Managed Care Program Summary

Geographic Area Served

Risk-based Capitation Risk-based Capitation Risk-based Capitation Fee-For-Service Non-risk Capitation

1915(a) 1915(b) 1915(b) 1932(a) 1915(a)

41,932 50,500 56,410 22,426 15,157

Medicaid Managed Care Program Summary

Geographic Area Served

Medicaid Managed Care Program Summary

Geographic Area Served

AIDS Healthcare Foundation, Inc.

Non-risk Capitation Non-risk Capitation Fee-For-Service

Alternative Medicine Integration

Hillsborough, Pasco, Pinellas

Alzheimer's Waiver Service Provider

Broward, Dade, Palm Beach, Pinellas

Risk-based Capitation Risk-based Capitation

Long Term Care PIHP

1115 1915(b) 1115 1915(b) 1915(b)

22,262 175,971 4,410 20,981 85

Medicaid Managed Care Program Summary

Geographic Area Served

1915(b) 1915(b) 1115 1915(b) PACE

27,039 70,965 29,032 188,934 231