Lexology April 25, 2024
On May 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) will publish the “Ensuring Access to Medicaid Services Rule” (the “Access Rule”), which implements policy changes aimed at improving access to care in the Medicaid program across fee-for-service, managed care, and home-and-community-based services (“HCBS”) programs.1 Among other changes, the finalized Access Rule (the “Final Rule”) will require that eighty percent (80%) of all Medicaid payments made to HCBS must be spent on compensation paid to direct care workers. While the so-called “HCBS Payment Adequacy Requirement” will not take effect for six years from the date of the Access Rule’s adoption (or 2030), this federal minimum payment standard—to the extent applicable to specific forms of HCBS—will require significant programmatic...
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