Last week, the Centers for Medicare & Medicaid Services (CMS) unveiled two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM), that together address access to and quality of care across Medicaid programs.
HCAOA’s Policy Committee is currently reviewing the proposed rules and will provide additional information.
If adopted as proposed, the rules would attempt to establish national standards for access to care regardless of whether that care is provided through managed care plans or directly by states through fee-for-service (FFS). Specifically, they would establish access standards through Medicaid or CHIP managed care plans as well as transparency for Medicaid payment rates to providers.
Within the HCBS realm, the proposed rule seeks to: