Contracts

MO HealthNet Managed Care Health Plans

MO HealthNet Managed Care health plans contract with the State of Missouri, Department of Social Services, MO HealthNet Division, to provide a managed care medical service delivery system to service managed care enrollees meeting specified eligibility criteria. These MO HealthNet Managed Care health plans operate in all three regions.

Health plan name and contract number for Eastern, Central and Western Regions:

Enrollment Broker

The MO HealthNet Benefits Manager contracts with the State of Missouri, Department of Social Services, MO HealthNet Division, to provide education, outreach, and enrollment activities for the MO HealthNet Managed Care Program.

Broker name and contract number:

External Quality Review

The EQR contractor contracts with the State of Missouri, Department of Social Services, MO HealthNet Division, to conduct an annual External Quality Review (EQR) of MO HealthNet Managed Care Organizations (MCOs). The purpose of the contracts is to ensure performance by the MCOs is in accordance with state agency requirements, federal rules, protocols, and regulations.

Contractor name and contract number:

Section 1115 Women’s Health Services Program Waiver & Children’s Health Insurance Program Evaluation

The contractor contracts with the State of Missouri, Department of Social Services, MO HealthNet Division, to collect and analyze information about the 1115 Women’s Health Services Program and CHIP populations. The purpose is to evaluate and study the impact of state agency policy decisions about the 1115 Women’s Health Services Program Waiver and CHIP programs on the enrollees in the programs and on program participation by the uninsured.

Contractor name and contract number: