The Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking to rescind outdated 2015 requirements that impose complex administrative burdens on states without meaningful impact to beneficiaries.
This proposed rule is designed to help streamline federal oversight of access to care requirements that protect Medicaid beneficiaries. CMS anticipates that the proposed rule would, if finalized, result in overall cost savings for state partners that could be redirected to better serve the needs of their beneficiaries.Concurrent with the proposed rule, CMS is also issuing guidance to states to remind them of their ongoing statutory responsibilities to ensure appropriate access to care for beneficiaries, while also outlining a strategy to develop a more comprehensive approach to monitoring access in Medicaid.
If the proposed rule is finalized, CMS would replace the ongoing access reviews required by current regulations with a more comprehensive and outcomes-driven approach to monitoring access across delivery systems, developed through workgroups and technical expert panels that include key state and federal stakeholders.
To view more details about the proposed rulemaking and provide input, see the Federal Register notice.