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MississippiCAN Resources

Managed Care – MississippiCAN (MSCAN) and Children’s Health Insurance Program (CHIP) Forms

MSCAN and CHIP Forms

Title File Name Caption Date
CHIP-Change-of-Plan-Form-for-Mandatory-Groups CHIP-Change-of-Plan-Form-for-Mandatory-Groups.pdf September 9, 2019 8:55 pm
CHIP Enrollment Form CHIP-Enrollment-Form.pdf June 16, 2015 10:06 pm
MississippiCAN Enrollment Form for Optional Groups MississippiCAN-Enrollment-Form-for-Optional-Groups.pdf August 7, 2018 7:46 pm
MississippiCAN Enrollment Form for Mandatory Groups MississippiCAN-Enrollment-Form-for-Mandatory-Groups.pdf August 7, 2018 7:47 pm
MississippiCAN Change of Plan Form for Optional Groups MississippiCAN-Change-of-Plan-Form-for-Optional-Groups.pdf August 7, 2018 7:52 pm
MississippiCAN Change of Plan Form for Mandatory Groups MississippiCAN-Change-of-Plan-Form-for-Mandatory-Groups.pdf August 7, 2018 7:50 pm
2019 MississippiCAN Provider Survey Provider-Survey-2019.pdf August 26, 2019 5:43 pm
2020 Provider Workshop Webinar 2020-Provider-Workshop-Webinar.pdf October 21, 2020 9:45 pm
MississippiCAN Comparison Chart MississippiCAN-Comparison-Chart.pdf October 4, 2022 8:03 pm
CHIP Comparison Chart CHIP-Comparison-Chart.pdf October 4, 2022 8:03 pm


MississippiCAN Contracts

UnitedHealthcare Community Plan

Jan. 2011 – June 2014 contract

July 2014 – June 2018 contract

July 2017 – June 2023 contract documents

Children’s Health Insurance Program (CHIP) Contracts


Mississippi External Quality Review


Managed Care Program Annual Report (MCPAR) for Mississippi: Mississippi Coordinated Access Network (MSCAN)

In accordance with 42 CFR § 438.66(e), the Division of Medicaid must submit to the Centers for Medicare and Medicaid Services (CMS) a report on each of its managed care programs which contains data from all managed care organizations. The June 28, 2021 CMCS Informational Bulletin released guidance on the Annual Managed Care Program Report, part of CMS’s overall strategy to improve access to services by supporting Federal and state access monitoring for Medicaid beneficiaries within a managed care delivery system.

As defined by the regulation, the report will collect information in the following categories:

  1. Program enrollment and service area expansions
  2. Financial performance
  3. Encounter data reporting
  4. Grievances, appeals, and state fair hearings
  5. Availability, accessibility, and network adequacy
  6. Delegated entities
  7. Quality and performance measures
  8. Sanctions and corrective action plans
  9. Beneficiary support system (BSS)
  10. Program integrity

All 10 categories apply to Managed Care Organizations (MCOs), Prepaid Inpatient Health Plans (PIHPs), and Prepaid Ambulatory Health Plans (PAHPs).


Mental Health Resources