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CMS Posts Sweeping New Medicaid Managed Care Regs

CMS has released the pre-publication version of the long-awaited and highly anticipated Medicaid managed care regulations. The proposed rule is intended to "modernize the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems." According to the summary accompanying the proposed rule, it would:

  • align the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through QHPs and Medicare Advantage plans
  • strengthen actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates
  • promote the quality of care and strengthen efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries
  • ensure appropriate beneficiary protections and enhance policies related to program integrity, and
  • require states to establish comprehensive quality strategies for their Medicaid and CHIP programs regardless of how services are provided to beneficiaries

The document is scheduled to be published in the June 1 Federal Register with comments due no later than July 27, 2015.

View the pre-publication version of this rule here.

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This page contains a single entry from the blog posted on May 26, 2015 5:50 PM.

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