PRESS RELEASE
FOR IMMEDIATE RELEASE
March 22nd, 2018
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
CMS
Proposes Regulation to Alleviate State Burden
Proposed
rule furthers President Trump’s commitment to “cutting the red tape” by
relieving states of burdensome paperwork requirements
Today, The Centers for Medicare & Medicaid Services (CMS) issued a
notice of proposed rulemaking (NPRM) that would provide state flexibility
from certain regulatory access to care requirements within the Medicaid
program. Specifically, the NPRM would exempt states from requirements
to analyze certain data and monitor access when the vast majority of their
covered lives receive services through managed care plans. CMS regulations
separately provide for access requirements in managed care programs.
Additionally, the NPRM would provide similar flexibility to all states when
they make nominal rate reductions to fee-for-service payment rates.
States have raised concerns over undue administrative burden associated
with meeting the requirements of the final rule, Medicaid Program; Methods
for Assuring Access to Covered Medicaid Services (published in November
2015). Specifically, states with few Medicaid members enrolled in
their fee-for-service program or when members are only temporarily
enrolled, and states making small reductions to fee-for-service payment
rates, have urged CMS to consider whether analyzing data and monitoring
access in that program is a beneficial use of state resources. To
respond to these concerns, the NPRM proposes the following changes:
- States with an
overall Medicaid managed care penetration rate of 85% or greater
(currently, 17 States) would be exempt from most access monitoring
requirements.
- Reductions to
provider payments of less than 4% percent in overall service category
spending during a State fiscal year (and 6% over two consecutive
years) would not be subject to the specific access analysis..
- When states reduce
Medicaid payment rates, they would rely on baseline information
regarding access under current payment rates, rather than be required
to predict the effects of rate reductions on access to care, which
states have found very difficult to do.
This notice furthers President Trump’s commitment to “cut the red tape”
and is part of a series of initiatives aimed at helping states focus more
resources and time on patient outcomes in their Medicaid programs. In
a speech to the National Association of Medicaid Directors last year, CMS
Administrator Seema Verma emphasized CMS’s
commitment to “turn the page in the Medicaid program” by giving states more
freedom to design innovative programs that achieve positive results for the
people they serve. In total, the proposed changes are estimated to reduce
state administrative burden by 561 hours with a total savings of over $1.6
million.
These proposed regulatory changes do not change the underlying statutory
responsibilities for states to ensure that Medicaid recipients have
appropriate access to services. These efforts are instead designed to
support CMS efforts to move away from micromanaging state programs and
instead focus on measuring program outcomes and holding states accountable
for achieving results.
“Today’s proposed rule builds on our commitment to strengthening the
Medicaid program and assist those it serves through state partnerships that
improve quality, enhance accessibility and achieve outcomes in the most
cost effective manner,” said CMS Administrator Seema Verma. “These new
policies do not mean that we aren’t interested in beneficiary access, but
are intended to relieve unnecessary regulatory burden on states, avoid
increasing administrative costs for taxpayers, and refocus time and resources
on improving the health outcomes of Medicaid beneficiaries.”
In a March
14, 2017 letter to Governors, the Department of Health and Human
Services and CMS announced a new commitment “to
empower all states to advance the next wave of innovative solutions to
Medicaid’s challenges – solutions that focus on improving quality,
accessibility, and outcomes in the most cost-effective manner.”
For more information regarding CMS 2406-P: Methods for Assuring Access
to Covered Medicaid Services – Exemptions for States with High Managed Care
Penetration Rates and
Rate Reduction Threshold, and to make a comment regarding the proposed
rule, please visit (https://www.medicaid.gov/medicaid/access-to-care/index.html)
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