Four Ways States Can Improve MCO Data Reporting

Published in FierceHealthcare

It's more important than ever for states and Medicaid managed care organizations to provide accurate and timely encounter data for the federal government, according to a new Guidehouse report.

CMS will provide further guidance on its requirements for encounter data accuracy, but in the meantime, the report recommends that states:

  • Begin review of service level agreements for encounter data reporting well in advance of new contracts with MCOs
  • Have clear contract requirements that use sanctions and incentives to promote proper encounter reporting from MCOs
  • Employ staff dedicated to monitoring and enforcing encounter submissions
  • Work with MCOs to correct any issues with deficient encounter data reporting

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