CMS Updates Medicaid Regulations

The Centers for Medicare & Medicaid Services (CMS) published two significant updates to its Medicaid regulations on May 10, 2024. The two Final Rules, a Medicaid Access Rule and a Medicaid Managed Care Rule, impose new requirements on states and Medicaid managed care plans that will enhance and standardize reporting, monitoring, and evaluation of Medicaid access to services.

Medicaid Access Rule

This rule includes provisions that create new transparency and consultation requirements for fee-for-service (FFS) provider payment rates, including a requirement for states to publish analyses comparing the Medicaid FFS rates for certain services against corresponding Medicare FFS rates, the establishment of an “interested parties’ advisory group” to advise and consult on payment rates for certain HCBS, and significant...

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