CMS to issue new Medicaid managed care rules for comment May 26, 2015 Managed Care, Medi-Cal CMS, Long Term Care, Medi-Cal, Centers for Medicare and Medicaid Services 0 For the first time since 2002, the Obama administration has announced that it will propose new federal regulations for Medicaid managed care. The Centers for Medicare and Medicaid Services (CMS) is slated to issue a Notice of Proposed Rulemaking sometime in 2015. Industry stakeholders have already submitted input and recommendations to CMS to consider in the final drafting of the new rules. Indications from those who have already commented on agency drafts are that the new rules will address rate setting, stronger beneficiary protections and easing beneficiary transitions between Medicaid managed care organizations, Medicare Advantage plans and marketplace qualified health plans. The new rules will also address managed care for long-term care for the first time. As baby boomers age, long-term managed care is widely recognized as one of the toughest coming challenges for the U.S. health care system – and Medicaid managed long-term care will provide a unique challenge for states. The new rules are rumored to potentially address provider network adequacy, with an emphasis on ensuring plan directories are accurate along with better protections for beneficiary protections, both issues the California Medical Association (CMA) has continuously advocated for on the national and state levels. CMA will continue to track the release of these regulations and anticipates providing comments. Comments are closed.
