data.medicaid.gov
Managed Care Programs By State
The Managed Care Program Features lists characteristics of each state’s Medicaid managed care programs, including federal operating authority, population enrolled, and benefits covered.
Freshness
- Last posted
- Period covered
- Update frequency
Dates as CMS lists them in its catalog.
Columns 60
| Column | What it means | Type |
|---|---|---|
Featuresfeatures | text | |
Program typeprogram_type | text | |
Statewide or region-specific?statewide_or_regionspecific | text | |
Federal operating authorityfederal_operating_authority | text | |
Program start dateprogram_start_date | text | |
Waiver expiration date (if applicable)waiver_expiration_date_if_applicable | text | |
If the program ended in 2024, indicate the end dateif_the_program_ended_in_2024_indicate_the_end_date | text | |
Populations enrolled: Low-income adults not covered under ACA Section VIII (excludes pregnant women and people with disabilities)populations_enrolled_lowincome_adults_not_covered_under_aca_0778 | text | |
Populations enrolled: Low-income adults covered under ACA Section VIII (excludes pregnant women and people with disabilities)populations_enrolled_lowincome_adults_covered_under_aca_sec_03d9 | text | |
Populations enrolled: Aged, Blind or Disabled Children or Adultspopulations_enrolled_aged_blind_or_disabled_children_or_adults | text | |
Populations enrolled: Non-Disabled Children (excludes children in foster care or receiving adoption assistance)populations_enrolled_nondisabled_children_excludes_children_1dda | text | |
Populations enrolled: Individuals receiving Limited Benefits (excludes partial duals)populations_enrolled_individuals_receiving_limited_benefits_facc | text | |
Populations enrolled: Full Dualspopulations_enrolled_full_duals | text | |
Populations enrolled: Children with Special Health Care Needspopulations_enrolled_children_with_special_health_care_needs | text | |
Populations enrolled: Native American/Alaskan Nativespopulations_enrolled_native_americanalaskan_natives | text | |
Populations enrolled: Foster Care and Adoption Assistance Childrenpopulations_enrolled_foster_care_and_adoption_assistance_ch_b424 | text | |
Populations enrolled: Enrollment choice periodpopulations_enrolled_enrollment_choice_period | text | |
Populations enrolled: Enrollment broker name (if applicable)populations_enrolled_enrollment_broker_name_if_applicable | text | |
Populations enrolled: Notes on enrollment choice periodpopulations_enrolled_notes_on_enrollment_choice_period | text | |
Benefits covered: Inpatient hospital physical healthbenefits_covered_inpatient_hospital_physical_health | text | |
Benefits covered: Inpatient hospital behavioral health (MH and/or SUD)benefits_covered_inpatient_hospital_behavioral_health_mh_an_4041 | text | |
Benefits covered: Outpatient hospital physical healthbenefits_covered_outpatient_hospital_physical_health | text | |
Benefits covered: Outpatient hospital behavioral health (MH and/or SUD)benefits_covered_outpatient_hospital_behavioral_health_mh_a_ceee | text | |
Benefits covered: Partial hospitalizationbenefits_covered_partial_hospitalization | text | |
Benefits covered: Physicianbenefits_covered_physician | text | |
Benefits covered: Nurse practitionerbenefits_covered_nurse_practitioner | text | |
Benefits covered: Rural health clinics and FQHCsbenefits_covered_rural_health_clinics_and_fqhcs | text | |
Benefits covered: Clinic servicesbenefits_covered_clinic_services | text | |
Benefits covered: Lab and x-raybenefits_covered_lab_and_xray | text | |
Benefits covered: Prescription drugsbenefits_covered_prescription_drugs | text | |
Benefits covered: Prosthetic devicesbenefits_covered_prosthetic_devices | text | |
Benefits covered: EPSDTbenefits_covered_epsdt | text | |
Benefits covered: Case managementbenefits_covered_case_management | text | |
Benefits covered: SSA Section 1945-authorized Health Homebenefits_covered_ssa_section_1945authorized_health_home | text | |
Benefits covered: Home health services (services in home)benefits_covered_home_health_services_services_in_home | text | |
Benefits covered: Family planningbenefits_covered_family_planning | text | |
Benefits covered: Dental services (medical/surgical)benefits_covered_dental_services_medicalsurgical | text | |
Benefits covered: Dental (preventative or corrective)benefits_covered_dental_preventative_or_corrective | text | |
Benefits covered: Personal care (state plan option)benefits_covered_personal_care_state_plan_option | text | |
Benefits covered: HCBS waiver servicesbenefits_covered_hcbs_waiver_services | text | |
Benefits covered: Private duty nursingbenefits_covered_private_duty_nursing | text | |
Benefits covered: ICF-IDDbenefits_covered_icfidd | text | |
Benefits covered: Nursing facility servicesbenefits_covered_nursing_facility_services | text | |
Benefits covered: Hospice carebenefits_covered_hospice_care | text | |
Benefits covered: Non-Emergency Medical Transportationbenefits_covered_nonemergency_medical_transportation | text | |
Benefits covered: Institution for Mental Disease inpatient treatment for people ages 21-64 defined by 42 CFR 438.6(e) as an 'in lieu of' benefitbenefits_covered_institution_for_mental_disease_inpatient_t_448a | text | |
Benefits covered: Other (e.g., nurse midwife services, freestanding birth centers, podiatry)benefits_covered_other_eg_nurse_midwife_services_freestandi_bfd7 | text | |
Quality assurance and improvement: HEDIS data required?quality_assurance_and_improvement_hedis_data_required | text | |
Quality assurance and improvement: CAHPS data required?quality_assurance_and_improvement_cahps_data_required | text | |
Quality assurance and improvement: Accreditation required?quality_assurance_and_improvement_accreditation_required | text | |
Quality assurance and improvement: Accrediting organizationquality_assurance_and_improvement_accrediting_organization | text | |
Quality assurance and improvement: EQRO contractor name (if applicable)quality_assurance_and_improvement_eqro_contractor_name_if_a_f2dc | text | |
Performance incentives: Payment bonuses/differentials to reward plansperformance_incentives_payment_bonusesdifferentials_to_rewa_eece | text | |
Performance incentives: Preferential auto-enrollment to reward plansperformance_incentives_preferential_autoenrollment_to_rewar_ab96 | text | |
Performance incentives: Public reports comparing plan performance on key metricsperformance_incentives_public_reports_comparing_plan_perfor_42d0 | text | |
Performance incentives: Withholds tied to performance metricsperformance_incentives_withholds_tied_to_performance_metrics | text | |
Performance incentives: MCOs/PHPs required or encouraged to pay providers for value/quality outcomesperformance_incentives_mcosphps_required_or_encouraged_to_p_bf59 | text | |
Participating plans in Programparticipating_plans_in_program | text | |
Program Notesprogram_notes | text | |
Statestate | text |
No column matches that filter.
At a glance
- Catalog
- data.medicaid.gov
- Publisher
- Centers for Medicare & Medicaid Services (CMS), data.medicaid.gov
- Rows
- 183
- Columns
- 60
- State column
state- Topics
- Medicaid and CHIP
- Contact
- Medicaid.gov@cms.hhs.gov
API
Free, no key needed. This request returns the first 10 rows as JSON:
https://data.medicaid.gov/api/1/datastore/query/ef16c490-861a-4b1f-9e6d-f321abdcaab1/0?limit=10
To keep only one state, filter on the state column.
Versions 9
The newest version is the one linked above. Older releases stay on the official site.
- 2024posted Feb 11, 2026
- 2023posted Feb 12, 2026
- 2022posted Oct 16, 2024
- 2021posted Jul 21, 2023
- 2020posted Oct 17, 2025
- 2019posted Jun 13, 2022
- 2018posted Oct 17, 2025
- 2017posted Oct 17, 2025
Show 1 older versions
- Managed Care Programs by Stateposted Oct 17, 2025
CMS's description
The Managed Care Program Features lists characteristics of each state’s Medicaid managed care programs, including federal operating authority, population enrolled, and benefits covered.
The summary at the top is the first sentence of this description. Record id mcd:ef16c490-861a-4b1f-9e6d-f321abdcaab1. This record as JSON.