Medicaid Access and Managed Care Final Rule Summaries

CHA has created summaries for both final rules outlining the provisions most relevant to children’s health and hospitals.

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.

Hand

Contact Us

For more information, connect with us.

(202) 753-5342
(202) 753-5521

Related Content

The Transforming Power of Sickle Cell Gene Therapy (and Why Access Is Important)

A revolutionary therapy takes some children’s lives to new heights. Others are left out.

Sep. 12, 2025

Children’s Hospitals Call on Congress to Confront Alarming Rise in Youth Suicide

As National Suicide Prevention Month begins, Children’s Hospital Association urges lawmakers to expand access to pediatric mental health care and prevention programs.

Sep. 11, 2025

The Budget Reconciliation Bill's Financial Impact on Children’s Hospitals

The budget reconciliation legislation will have a devastating effect on the financial viability of America’s children’s hospitals.

Sep. 04, 2025