PM20
Change in Circumstances
CMS-required outcome
A state user can view information from a managed care plan describing changes in a network provider's circumstances that may affect the provider's eligibility to participate in Medicaid, including termination of the provider agreement.
Default metrics
- List of providers by provider type who have been released from the managed care entity due to:
- Change in state residence
- Investigation of FWA
- Death
- Others as defined by state
- Include provider state Medicaid status
Regulatory sources