(May 2, 2024) - On April 22, the Centers for Medicare & Medicaid Services released a final rule focused on ensuring access to services for Medicaid beneficiaries in fee-for-service delivery systems in keeping with the Administration’s objectives to improve access for Medicaid and Children’s Health Insurance Program beneficiaries. The finalized provisions are intended to increase transparency, improve accountability and ensure standardized data and monitoring.
Key Highlights:
- Medical Advisory Committee and Beneficiary Advisory Group: Renames and expands the scope of states’ Medical Care Advisory Committees and requires states to establish a Beneficiary Advisory Group. The MACs and the BAGs are intended to promote transparency and accountability amongst the state, stakeholders and Medicaid beneficiaries related to the effective administration of the Medicaid program.
- Fee-for-service Provider Payment Rate Transparency: Removes state access monitoring review plan requirements and replaces them with new payment rate transparency standards and documentation requirements. It also requires states to conduct a payment rate analysis for certain services every two years.
- Home- and Community-Based Services: Strengthens safeguards and provides for a more coordinated administration of policies and procedures for individuals receiving Medicaid-covered home and community-based services.