The AAMC on Nov. 1 submitted comments in response to the Centers for Medicare & Medicaid Services’ (CMS’) proposed rule to streamline enrollment and eligibility into Medicaid and the Children’s Health Insurance Program (CHIP) [refer to Washington Highlights, Sept. 9]. The comment letter expressed support for the CMS’ proposals to ensure eligible individuals are enrolled and remain enrolled in Medicaid and CHIP.
The comment letter called on the CMS to review Medicaid reimbursement rates to ensure access to needed medical care. Currently, Medicaid rates are lower than both Medicare and commercial insurance. These low rates jeopardize patient access to providers, including behavioral health specialists.
“Despite low reimbursement rates, AAMC-member teaching hospitals and their associated faculty practice plans continue to work to ensure access for all Medicaid patients. However, low Medicaid rates may place even greater challenges and a disproportionate burden on these providers if other providers choose not to accept new Medicaid patients,” the letter stated.
The comment letter also called on the CMS to strengthen network adequacy standards for Medicaid Managed Care Organizations (MCOs). The use of narrow networks by MCOs has expanded, often excluding teaching hospitals and their associated providers who furnish primary, specialty, and subspecialty care and behavioral health services. Minimum network adequacy standards for MCOs would address access and ensure the availability of subspecialty and behavioral health care for Medicaid beneficiaries.