Missouri Medicaid Faces $1 Billion Federal Penalty Over Payment Error Rate by 2029
Missouri's Medicaid program could face over $1 billion in federal penalties under the One Big Beautiful Bill Act passed by Congress in 2025 unless it reduces its payment error rate below 3% by October 2029. The legislation also imposes new federal mandates that will affect state program operations. Advocates are raising questions about the role of managed care organizations in meeting these requirements as the state enters a period of significant budget pressure. The stakes are particularly high for Missouri, which faces enforcement timelines tighter than many other states.
State Medicaid agencies must prepare for aggressive error rate targets and potential budget impacts from federal enforcement actions tied to payment accuracy, with managed care arrangements likely under scrutiny as a compliance strategy.
Managed Care · Finance
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