This expert perspective reviews how Medicaid programs in Connecticut, Massachusetts and Rhode Island have engaged with commercial payers, providers, patients, advocates and other parties to create and adhere to multi-payer aligned measure sets. It describes the benefits to Medicaid agencies of participating in aligned measure set efforts, as well as tips and resources for Medicaid agencies intersted in measure alignment.
CMS Proposed Rules Part 1: Access to Care and Transparency
On Tuesday, May 23, State Health and Value Strategies hosted a webinar providing 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 first webinar in this three-part series, experts from Manatt Health provided an overview of the access to care and access monitoring proposals included in both rules. 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.