Missouri Laws 208.431 – Medicaid managed care organization reimbursement allowance, amount
1. For purposes of sections 208.431 to 208.437, the following terms mean:
(1) “Engaging in the business of providing health benefit services”, accepting payment for health benefit services;
Terms Used In Missouri Laws 208.431
- Contract: A legal written agreement that becomes binding when signed.
- following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020
- State: when applied to any of the United States, includes the District of Columbia and the territories, and the words "United States" includes such district and territories. See Missouri Laws 1.020
(2) “Medicaid managed care organization”, a health benefit plan, as defined in section 376.1350, with a contract under 42 U.S.C. § 1396b(m) to provide benefits to Missouri MC+ managed care program eligibility groups.
2. Beginning July 1, 2005, each Medicaid managed care organization in this state shall, in addition to all other fees and taxes now required or paid, pay a Medicaid managed care organization reimbursement allowance for the privilege of engaging in the business of providing health benefit services in this state.
3. Each Medicaid managed care organization’s reimbursement allowance shall be based on a formula set forth in rules, including emergency rules if necessary, promulgated by the department of social services. No Medicaid managed care organization reimbursement allowance shall be collected by the department of social services if the federal Center for Medicare and Medicaid Services determines that such reimbursement allowance is not authorized under Title XIX of the Social Security Act. If such determination is made by the federal Center for Medicare and Medicaid Services, any Medicaid managed care organization reimbursement allowance collected prior to such determination shall be immediately returned to the Medicaid managed care organizations which have paid such allowance.