OMB control number

Medicaid Managed Care and Supporting Regulations (CMS-10108)

OMB 0938-0920 · HHS/CMS.

OMB 0938-0920

These information collections requirements implement regulations that allow states greater flexibility to implement mandatory managed care programs, implement new beneficiary protections, and eliminate certain requirements viewed by state agencies as impediments to the growth of managed care programs. Information collected includes information about managed care programs, grievances and appeals, enrollment broker contracts, and managed care organizations capacity to provide health care services.

The latest form for Medicaid Managed Care and Supporting Regulations (CMS-10108) expires 2026-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form
CMS-10108_Supporting Statement A (2023 version 9).docx (document unavailable)
Supporting Statement A
Supplementary Document
OMB Details

Medicaid Managed Care Regulations (States)

Federal Enterprise Architecture: Health - Health Care Services

Form CMS-10108MLR Reporting Toolwww.medicaid.gov/medicaid/managed-care/downloads/mlr-reporting-template.xlsxForm
Form CMS-10108Network Adequacy and Access Assurances Toolwww.medicaid.gov/medicaid/managed-care/downloads/network-assurances-template.xlsxForm and instruction
Form CMS-10108Managed Care Program Annual Report (MCPAR)www.medicaid.gov/medicaid/managed-care/downloads/amcpr-reporting-template.xlsxForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.