CMS proposed an exemption from certain reporting requirements and beneficiary access monitoring regulations for states delivering at least 85 percent of their Medicaid coverage through managed care.
Here are six insights.
1. The proposed rule would reduce state administrative burden by an estimated 561 hours, saving more than $1.6 million.
2. Seventeen states would currently qualify. More could become exempt from the access analysis by making reductions to provider payments of less than 4 percent in overall service category spending during their fiscal year, and 6 percent over two consecutive years.
3. CMS regulations separately provide beneficiary access guidelines for managed care programs.
4. When states reduce Medicaid payment rates, they would rely on baseline access information under current payment rates rather than predicting the effects of rate reductions on access.
5. States making small reductions to fee-for-service payment rates and states with few beneficiaries enrolled in their fee-for-service program, or beneficiaries enrolled just temporarily, have raised concerns about the administrative burdens of the final rule on Medicaid CMS issued in November 2015. They urged to CMS to evaluate whether analyzing data and monitoring access were effective uses of state resources.
6. "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," the CMS announcement said. "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."