Friday, May 14, 2021
HomeLatest NewsFederal NewsCMS Issues Medicaid Managed Care Final Rule

CMS Issues Medicaid Managed Care Final Rule

The Centers for Medicare and Medicaid Services (CMS) issued a Final Rule for Medicaid and Children’s Health Insurance Program (CHIP) Managed Care programs. The Final Rule finalizes policies form a Notice of Proposed Rulemaking issued in November 2018. These new rules follow a substantial update made to the same regulations in 2016 to Medicaid and CHIP managed care programs. CMS noted the impetus of the new rules as the result of state and provider feedback charging that the 2016 rules were overly prescriptive and administratively burdensome. CMS worked with the National Association of Medicaid Directors and state Medicaid Directors to inform the rule making process.

The new final rule significantly alters the following areas:

1.         Setting Actuarially Sound Capitation Rates (Medicaid)
2.         Pass-Through Payments (Medicaid)
3.         State-Directed Payments (Medicaid)
4.         Network Adequacy Standards (Medicaid and CHIP)
5.         Risk Sharing Mechanisms (Medicaid)
6.         Quality Rating System (Medicaid and CHIP)
7.         Appeals and Grievances (Medicaid and CHIP)
8.         Requirements for Beneficiary Information (Medicaid and CHIP)

A fact sheet on the Final Rule is available here.

Stay Connected

Unified Voice Newsletter

Events This Month

may

17mayAll DayThe Interdisciplinary Team: Key Skills for Hospice Managers4-week course(All Day: monday) Event Type :Education Events,Webinar

17may8:00 am5:00 pmPrimary Care Management of Addiction: Getting your Clinic off the Ground8:00 am - 5:00 pm CST Event Type :Community Events,Education Events

18may10:00 am11:30 am2021 INPATIENT/OUTPATIENT SDAHO VIRTUAL REGIONAL MEETING10:00 am - 11:30 am CST Event Type :Education Events

18may12:00 pm1:00 pmKey Considerations for Expanding Telehealth and RPMWebinar12:00 pm - 1:00 pm Event Type :Education Events,Webinar

18may12:00 pm1:00 pmPerson Centered Goal Discovery for People Living With DementiaWebinar12:00 pm - 1:00 pm CST Event Type :Education Events,Webinar

X

Select list(s) to subscribe to


By submitting this form, you are consenting to receive marketing emails from: SDAHO, 3708 W Brooks Place, Sioux Falls, SD, 57106, http://sdaho.org. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact