get_medicaid_mco_enrollment

Returns Medicaid managed-care enrollment for ONE state: the annual CMS 'Enrollment by Program and Plan' roster (each managed-care program x plan with SEPARATE Medicaid-only, dual and total member counts and a value_status per count, plus parent organization) for the requested or latest calendar year (2016-2024); the state's TOTAL Medicaid and CHIP enrollment from the CMS monthly state report for the latest 12 reporting months (context: all delivery systems, managed care and fee-for-service, CHIP separate); and, for the four T-MSIS dashboard pilot states (AZ, MI, NV, NM), the MCO roster with county footprint and service categories; and the state's OWN monthly plan-level publication for its latest month (45 jurisdictions). Inputs: state (required, 2-letter USPS code); optional year (plan-roster calendar year, defaults to the latest the state has); optional limit.

RETURNS a detail payload: value.summary (state, plan_year, plan_count, program_count, the SOURCE-PUBLISHED sum of plan total_enrollment where reported_numeric for the comprehensive_medical benefit scope ONLY, plus per-benefit-scope sums that must never be added together, with the count of rows that are suppressed / not reported, the latest monthly total Medicaid+CHIP / Medicaid / CHIP enrollment with its reporting_period, and a `blocks` map saying which sources have rows for this state); value.plans (one row per program x plan x region: benefit_scope (comprehensive_medical, behavioral_health, dental, pharmacy, ltss, pace, nemt, pccm, limited_benefit, unknown) with the rule that set it, medicaid_only / dual / total each with value + value_status, parent_organization, calendar_year, source_table); value.monthly (reporting_period, total_medicaid_and_chip_enrollment, total_medicaid_enrollment, total_chip_enrollment, adult / child enrollment, revision + final flags, source_table); value.mco_roster (mco_name, plan_category, county_count, service_categories, source_table; NO enrollment number); value.monthly_plans (the state-published plan rows for the latest monthly observation_period, statewide where the state publishes statewide rows, otherwise sub-state as published, each with reported_value, value_unit, value_status, row_role and source_url; never summed into a state total). Every number carries its as-of period and exact source table. Nothing is recomputed or reconciled across sources: Medicaid-only + dual is not re-summed, a published 0 is reported_zero_or_suppressed (never exact zero), and the annual plan roster is a different population and grain from the monthly state total. All sources are read WHERE is_current = true (monthly: is_latest_revision = true). An unknown state returns found=false.

SOURCE: CMS/Data.Medicaid.gov Medicaid Managed Care Enrollment by Program and Plan (state-reported, annual); CMS Medicaid & CHIP Application, Eligibility and Enrollment monthly state report; CMS Medicaid MCO Dashboard (T-MSIS, four pilot states); state Medicaid agencies' monthly managed-care enrollment reports (medicare_semantic.vw_medicaid_mco_enrollment_tracker_reported_observation_v2).