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​Managed Care Document Library

The document library below can be used to locate annual and quarterly reports as well as technical advisories. The library's content can be filtered and sorted to help you more easily find the information you are looking for.  

    • Use the Document Type filter to select the type of document(s) you are looking for.
    • Use the Year filter to view documents for a specific year.
    • You can also click the arrows next to the column headings (Title, Type, Year) to sort the information alphabetically or chronologically.

*Annual reports display enrollment by county while quarterly reports display enrollment by product.

For best experience, please use a desktop computer to access this page.

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Doc Num ⇧Title ⇳Type ⇳Year ⇳Field1 ⇳Field2 ⇳
  Annual Report 2019 Annual Report2019  
  Quarterly Report Q1 2019 Quarterly Report2019  
  Quarterly Report Q1 2020 Quarterly Report2020  
  Credentialing Standards - Provisional Credentialing Technical Advisory2006  
  Communicating the UR Decision Technical Advisory2005  
  Gatekeeper and Point-of-Service Plans Technical Advisory2004  
  Instruction for Appeal Transmittal Letters Technical Advisory2005  
  Credentialing Standards - Medical Director Sign-Off Technical Advisory2006  
  Managed Care Plan Termination of Specialists / Non-PCP Technical Advisory2006  
  Travel Distance to Participating Providers Technical Advisory2012  
  UR Denial Contract Language Technical Advisory2005  
  ​Access Review of Tiered Networks Technical Advisory2013  
  Managed Care Plan Complaints / Grievances Receipt Timeframe Technical Advisory2007  
  Quarterly Report Q2 2019 Quarterly Report2019  
  Quarterly Report Q2 2020 Quarterly Report2020  
  Quarterly Report Q3 2019 Quarterly Report2019  
  Quarterly Report Q3 2020 Quarterly Report2020  
  Quarterly Report Q4 2019 Quarterly Report2019  
  Quarterly Report Q4 2020 Quarterly Report2020  
  Provider Initiated Grievance Enrollee Consent Technical Advisory2004  
  External Grievance Process for MA MCOs - 28 Pa. Code § 9.707 Technical Advisory2021