(April 26, 2024) – CMS Announces Medicaid Access and Quality Rules Release
The Centers for Medicare & Medicaid Services is set to publish its final rules on Medicaid access and quality for fee-for-service and managed care programs Friday, May 10. Although the rules include many provisions that will enable coverage and ensure participants have fair access to the benefits to which they are entitled, the managed care rule will require Medicaid enrolled providers to periodically attest whether they are participating in Medicaid provider tax "hold harmless arrangements." Many other provider groups opposed the imposition of this provision, arguing CMS lacks the statutory authority to do so. The final rule defers the implementation of the attestation requirement until January 2028, which will allow time for the legality of the requirement to be reviewed.
CMS Releases Final Long-Term Care Minimum Staffing Regulation
The Centers for Medicare & Medicaid Services released a final rule containing minimum staffing requirements at long-term care facilities. The rule mandates long-term care facilities to provide a minimum of 3.48 hours per resident day in nursing staff time, including a minimum 0.55 HPRD of R.N. care and 2.45 HPRD of direct nurse aide care. The rule requires an RN on-site 24-7 for skilled nursing care. The rule will be implemented in three phases.
FTC Finalizes Sweeping Rule Barring Noncompete Agreements
The Federal Trade Commission finalized a rule that would ban noncompete agreements for nearly all occupations in the U.S. Once the rule is effective, employers will be required to notify employees currently subject to a noncompete agreement that the contract is no longer enforceable. The only contracts permitted to stay in effect are those with senior executives, defined as individuals in a policy-making position making more than $151,164 annually. Employers are prohibited from imposing new noncompete contracts with senior executives after the effective date of the rule.
The FTC's jurisdiction extends to for-profit entities, and numerous commenters to the proposed rule asserted it could not regulate nonprofit or governmental entities. However, the FTC claims in the final rule that such organizations are not "categorically outside the Commission’s authority." Because of the rule's far-reaching implications, litigation to stop its implementation is likely. The rule has not yet been published in the Federal Register but will take effect 120 days from the publication date.
Study Looks at Barriers to Opioid Use Disorder Treatment Among Rural Residents
In 2020, nearly three million people living in rural areas required treatment for a substance use disorder. Of these individuals, only 10 percent received treatment from a specialty facility and less than 1 percent received medication for opioid use disorder. A study published in Social Science & Medicine focuses on the unique barriers and challenges faced by patients living in nonmetropolitan areas. Themes include fear of withdrawal, close-knit communities that perpetuate drug use, stigma, limited availability of treatment in rural areas, lack of transportation and treatment facilities with strict, punitive policies, among others. By understanding the roadblocks faced by these community members, we can begin dismantling the policies and procedures creating inequitable access to treatment.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go ...
The Centers for Medicare & Medicaid Services is hosting a series of five webinars this summer focused on improving maternal health outcomes with an emphasis on substance abuse and hypertension treatment. Advance registration is required for each webinar. Following the webinar series, CMS will convene state-hosted affinity workgroups about maternal substance use and hypertension to complement the work of state-level maternal health improvement programs.