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  • Washington Highlights

    AAMC Sends Medicaid Managed Care Letter to CMS Administrator

    Mary Mullaney, Director, Hospital Payment Policies

    The AAMC May 22 sent a letter  to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma urging the agency not to abandon crucial standards or weaken federal oversight that help safeguard program integrity and the appropriate use of federal dollars. 

    The letter outlines specific provisions that the AAMC believes should be retained in the Medicaid Managed Care final rule, including: 

    • The development of actuarially sound capitation rates as outlined in the rule, including requiring states to identify the actual rate or rates it is planning to pay, are basic, but critical components in ensuring a reasonable rate-setting process.
    • States’ ability to address key policy goals by setting specific provider reimbursement requirements is critical to ongoing delivery system reform and to assuring access to key providers and services.
    • At a minimum, it is essential that no changes be made to requirements that states establish key network adequacy parameters and consider access indicators.
    • CMS should expand states’ ability to ensure that payments intended for hospitals and other providers are paid, including those for graduate medical education (GME). 

    The AAMC submitted comments on the proposed rule, which was published in April 2016 [see Washington Highlights, July 24, 2015].