Commonwealth Fund June 20, 2024
TOPLINES
New federal rules will allow states to direct Medicaid managed care plans to pay providers at rates equivalent to those of commercial plans and Medicare, with major implications for health care access and equity
Higher payment rates for Medicaid managed care providers will likely increase the pool of providers who serve Medicaid patients and strengthen the health care safety net
In April, the Centers for Medicare and Medicaid Services (CMS) finalized new Medicaid rules with major implications for access, equity, and the workforce. For decades, as managed care grew to be the dominant delivery system in the Medicaid program, CMS held the position that states could not direct how managed care plans paid providers under contract with plans. States...
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