Proposed Revisions to Medicaid Managed Care Weaken Requirements on Access
Regulations in place since 2016 that allowed state Medicaid programs flexibility to use managed care contracting and payments to drive reform in how health care is delivered and paid for are likely to remain largely intact, according to a new post on To the Point from Cindy Mann and Hailey Davis of Manatt Health. The Centers for Medicare and Medicaid Services is currently accepting comments on its proposed managed care rule for Medicaid and the Children’s Health Insurance Program through January 14.
The authors say, however, that certain provisions will weaken standards designed to ensure a sufficient network of health providers is available to serve enrollees. For example, the proposed regulations pull back the requirement that all states use “time and distance” travel standards. Instead, states will now only need to adopt a quantitative standard, such as minimum provider-to-enrollee ratios.
“In some parts of the country, people have trouble getting to a health professional’s office, especially for specialty services, even in good economic times,” the authors say. “Ultimately, nothing is more vital to the Medicaid delivery system than ensuring that children, pregnant women, people with disabilities, seniors, and other adults with Medicaid coverage have timely access to quality care.”
Medicaid managed care regulations_1x1 Read the post Proposed Revisions to Medicaid Managed Care Weaken Requirements on Access