The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule that would provide states with greater flexibility in how they meet access to care requirements within the Medicaid program.
The proposed rule addresses concerns associated with the 2015 final rule — which CHA commented on — that requires states proposing to reduce or restructure Medicaid fee-for-service payment rates to collect data through an Access Monitoring Review Plan and solicit input on the potential impact on beneficiaries’ access to care.
CMS proposes to exempt states with an overall Medicaid managed care penetration rate of 85 percent or greater from most fee-for-service access monitoring requirements; California’s current Medi-Cal managed care penetration rate is 80 percent.
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