The Contract Monitoring Branch (CMB) plays an important role in making sure Kentucky Medicaid members enrolled in a managed care organization (MCO) receive quality services and care.
Each MCO has a contract with the Department for Medicaid Services (DMS). The contract outlines the requirements each MCO must meet to serve Kentucky Medicaid members. CMB staff review reports, complete audits, investigate complaints, and work directly with MCOs to make sure the responsibilities of each contract are met. If staff find a problem, they work with the MCO to fix it through actions such as a letter of concern, a corrective action plan, or even fines. The CMB also serves as a connection point between the MCOs and DMS staff.