In this letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, MACPAC comments on a proposed rule that would require HHS to conduct a retrospective review of all regulations, including nearly all related to Medicaid and State Children’s Health Insurance Program (CHIP).
Although the Commission generally supports a retrospective review of regulations, Congress has already established procedures for regulatory promulgation, review, and public comment. Moreover, the proposed rule would create undue risk that rules essential to the successful operation of the programs may expire. States, providers, and managed care plans rely on stable and consistent regulatory guidance to meet their obligations under Medicaid and CHIP. The Commission expressed concern that beneficiaries’ access to care could also be affected by this uncertainty, particularly if rules related to eligibility or cost sharing limits were to expire.
The Commission also expressed concerns that the requirements would create additional unnecessary work that will distract HHS and the Centers for Medicare & Medicaid Services from other critical tasks affecting Medicaid and CHIP, particularly amid the COVID-19 pandemic and its resulting economic challenges.