On April 22, the Centers for Medicare and Medicaid Services (CMS) released both the Ensuring Access to Medicaid Services (Access) and Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality (Managed Care) final rules.
The Access final rule includes provisions that aim to increase transparency of provider payments and access to quality services within the fee-for-service delivery systems, including a focus on home- and community-based services.
The Managed Care final rule includes provisions that aim to improve state managed care programs by expanding state and plan requirements related to access, state directed payments, in lieu of services and settings (ILOSs), medical loss ratios (MLRs), and quality.
CHA has created summaries for both final rules outlining the provisions most relevant to children’s health and hospitals.
