208.431. Medicaid managed care organization reimbursement allowance, amount.

MISSOURI STATUTES AND CODES

208.431. Medicaid managed care organization reimbursement allowance, amount.

Medicaid managed care organization reimbursement allowance, amount.

208.431. 1. For purposes of sections 208.431 to 208.437, thefollowing terms mean:

(1) "Engaging in the business of providing health benefit services",accepting payment for health benefit services;

(2) "Medicaid managed care organization", a health benefit plan, asdefined in section 376.1350, RSMo, with a contract under 42 U.S.C. Section1396b(m) to provide benefits to Missouri MC+ managed care programeligibility groups.

2. Beginning July 1, 2005, each Medicaid managed care organization inthis state shall, in addition to all other fees and taxes now required orpaid, pay a Medicaid managed care organization reimbursement allowance forthe privilege of engaging in the business of providing health benefitservices in this state.

3. Each Medicaid managed care organization's reimbursement allowanceshall be based on a formula set forth in rules, including emergency rulesif necessary, promulgated by the department of social services. NoMedicaid managed care organization reimbursement allowance shall becollected by the department of social services if the federal Center forMedicare and Medicaid Services determines that such reimbursement allowanceis not authorized under Title XIX of the Social Security Act. If suchdetermination is made by the federal Center for Medicare and MedicaidServices, any Medicaid managed care organization reimbursement allowancecollected prior to such determination shall be immediately returned to theMedicaid managed care organizations which have paid such allowance.