Medicaid Primary Care Rate Increase (PCRI)

Medicaid Managed Care and Family Health Plus
PCRI Schedule of Reconciliation and Payments Dates

The Schedule is also available in portable document format (PDF, 1MB, 1pg.)

Quarter Calendar Year End of Quarter Encounter "Run Out"
Period for Plans
Reconciliation and
Certification due
to Department
Tentative
1 DOH Review of
Reconciliation and
Transmission of
Payment Request
to DOH Fiscal Manangement
Group(FMG)
2 Payments to
Plans based
on Medicaid
Claim Cycle
Plan Payment to Providers
January through March 2013 03/31/13 09/25/13 02/14/14 03/31/14 05/30/14 06/30/14
April through June 2013 06/30/13 09/25/13 02/14/14 03/31/14 05/30/14 06/30/14
July through September 2013 09/30/13 10/31/13 03/31/14 04/30/14 05/30/14 06/30/14
October through December 2013 12/31/13 01/31/14 04/30/14 05/30/14 06/30/14 07/31/14
January through March 2014 03/31/14 04/30/14 06/02/14 07/31/14 09/02/14 10/31/14
April through June 2014 06/30/14 07/31/14 09/02/14 10/31/14 12/01/14 02/02/15
July through September 2014 09/30/14 10/31/14 12/01/14 02/02/15 03/31/15 04/30/15
October through December 2014 12/31/14 01/31/15 03/02/15 04/30/15 06/01/15 07/31/15

1Transmission could be delayed if reconciliation requires resubmission from plan post DOH review

2Approximate date based on normal Medicaid Claim Cycle processing lag

3MCOs may report prior period PCRI "lump sum" requests in future reconciliation. A final cutoff date will be determined for each period.