Noteworthy News

CMS Proposes Easing Medicaid Access Requirement

Under a new regulation proposed by the Centers for Medicare & Medicaid Services, some states would no longer need to analyze access to care for their Medicaid population.

In a newly proposed regulation, CMS calls for eliminating the need for such a review in states with a high degree of Medicaid managed care penetration – 85 percent or more – and under certain circumstances when they reduce payments to providers.

According to CMS, existing regulations already enforce access requirements for Medicaid managed care plans, making a separate state obligation duplicative and unnecessary.

A CMS news release accompanying publication of the proposed rule quotes CMS administrator Seema Verma explaining that

These new policies do not mean that we aren’t interested in beneficiary access, but are intended to relieve unnecessary regulatory burden on states, avoid increasing administrative costs for taxpayers, and refocus time and resources on improving the health outcomes of Medicaid beneficiaries.

Learn more about the proposed regulation in this CMS news release and go here to see the proposed regulation itself.

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