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  • Washington Highlights

    CMS Releases Proposed Rule to Remove Requirements for Documenting and Assuring Beneficiary Access to Medicaid

    Andrew Amari, Hospital Policy and Regulatory Specialist

    The Centers for Medicare and Medicaid Services (CMS) July 11 issued a proposed rule to remove requirements for states to document whether Medicaid fee-for-service payments sufficiently assure beneficiary access to covered Medicaid services.

    The 2015 final rule, “Medicaid Program; Methods for Assuring Access to Covered Medicaid Services” currently requires states to develop and submit an access monitoring review plan for eight groups of services including primary care, specialist, and behavioral health services, among others. The rule also requires states to solicit input and notify the public of proposed changes to Medicaid payment rates.

    The proposed rule would remove these requirements but would preserve the requirement for states to maintain documentation of payment rates to be made available at CMS’s request. CMS seeks to replace the current reporting requirements with an outcomes-driven approach, but development of this new approach has not yet begun.

    The proposed rule will be published in the Federal Register on July 15 and comments will be due by Sept. 13.