CMS Proposed Rules Part 2: Coverage, Financing, Payment and Quality

On Friday, May 26, State Health and Value Strategies hosted a webinar that provided an overview of CMS’ recently released proposed rules: (1) “Managed Care Access, Finance, and Quality” (or the “Managed Care Proposed Rule”), which focuses on managed care delivery systems; and (2) “Ensuring Access to Medicaid Services” (or the “Access Proposed Rule”), which focuses on fee-for-service delivery systems and program improvements for home and community-based services across delivery systems. Together, these rules would reshape the federal regulatory landscape for Medicaid and CHIP, particularly with respect to standards for ensuring access to care, transparency and oversight of provider payment rates, engagement of people enrolled in Medicaid, quality measurement, and program accountability. During the second webinar in this three-part series, experts from Manatt Health focused exclusively on key provisions in the “Managed Care” proposed rule related to coverage, financing, payment, and quality. Presenters highlighted areas where CMS is requesting comment (due July 3, 2023) and reviewed considerations for state officials.

As a companion to this three-part webinar series, SHVS published a new expert perspective authored by Manatt Health that summarizes the two proposed rules, CMS Proposes Significant Medicaid Policy Changes for Access Monitoring, Managed Care, and HCBS.

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