North Dakota Medicaid Managed Care Contracts

The state of North Dakota operates two Medicaid managed care programs—a primary care case management (PCCM) program and a managed care organization (MCO) program.

The PCCM program serves the non-Medicaid expansion population. Members may choose their primary care provider (PCP). If they do not make a  selection, a PCP is assigned. PCP's receive a $2.00 per member per month case management fee.

The MCO program serves the Medicaid expansion population (childless adults with income up to 138% of the FLP). Under this program, the state contracts with one full-risk capitated health plan, Sanford Health Plan . . .