The Department of Human Services (DHS) published a notice in the October 17, 2026,
Pennsylvania Bulletin that provides information on the Medical Assistance (MA) and Children’s Health Insurance Program (CHIP) Managed Care Quality Strategy (MCQS) for Pennsylvania.
The Centers for Medicare & Medicaid Services (CMS) requires states to draft and implement a written quality strategy for assessing and improving the quality of health care and services furnished by managed care organizations (MCO) that have an agreement with DHS (see
42 CFR § 438.340(a) and
42 CFR 457.1240(e) (relating to managed care state quality strategy as well as quality measurement and improvement)).
The purpose of these regulations is to ensure members enrolled in Medicaid managed care programs have access to high-quality health care services provided by the state’s managed care organizations or entities. The MCQS for Pennsylvania’s MA and CHIP describes the managed care programs and structures, populations served, services offered, goals and objectives, quality-related initiatives, and strategies, as well as administrative processes used to ensure and monitor quality.
Pennsylvania’s draft
Medical Assistance and CHIP Managed Care Quality Strategy that was included in the PA Bulletin is available for review and comment.
Comments will be accepted until November 17, 2026,
and
must be
submitted electronically.
Please note, the Department of Human Services may update objectives, measures, baselines, and targets related to State-Directed Payments before they are finalized and submitted to CMS.
Additional information about the MCQS is on the
Managed Care Quality Strategy web page.
