It has been more than two years since the Centers for Medicare & Medicaid Services (CMS) released its Medicaid and CHIP Managed Care Final Rule in 2016. Under the Trump administration, CMS promised to review these regulations and recently issued proposed updates in November 2018. The proposed rules clarify CMS’ expectations and provide states some additional administrative flexibility to meet access, quality, and efficiency objectives.
The proposed rule will have limited overall impact on current Medicaid managed care operations for states and health plans. Many of the provisions are technical clarifications and tweaks to correct inadvertent references in the 2016 final Medicaid managed care regulations, align requirements with other government programs, or make clear CMS’ expectations.
The deadline for the public to submit comments on the proposed rule is Jan. 14, 2019. Subsequently, CMS will have to respond to public comments and issue a final rule before states will have to comply.