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• Risk-Bearing MCO Rate Certification Letter and Appendices – August 18, 2025

  Details:

  January 14, 2026

  • Medicaid
  • Managed Care

  Original Period Certified: July 2025 - June 2026. Actual Period Covered: July 2025 - Present.  The Louisiana Department of Health (LDH) has contracted with Milliman, Inc. to develop actuarially sound capitation rate ranges for the Healthy Louisiana program. Rate certification letters certify universal rates for a given time period, e.g., a state fiscal year. Rates shown in these letters are not the rates actually paid to participating Managed Care Organizations (MCO), as the actual rates paid to each MCO are risk-adjusted. That is, the rates paid to each MCO are the universal rates in the rate letter as adjusted for the expected costs of that MCO’s enrolled members, based on the members’ health conditions and health status. Original rate letters are often replaced with revised rate letters for the same time period. Revisions are necessary whenever there are programmatic changes (e.g., changes in services or populations covered) that impact rates effective within the original rate letter time period. Revisions may cover the entire period or only part of the period (going forward from the effective date of a program change prior to the end the period); rate letters are also sometimes supplemented with an issue-specific companion certification. Keywords: Managed Care 3.0, Capitation Rate, Certification-8-18-25

  Downloadable Assets:

  Medicaid Managed Care Rate Certification Appendix 2 Appendix 3 Appendix 7 Appendix 8 Appendix 9 Appendix 10 Appendix 11