MACPAC is charged with reviewing and examining access to care and services for Medicaid and State Children’s Health Insurance Program (CHIP) beneficiaries. Over the past decade, there have been several iterations of regulations for how states should monitor access to care and how managed care plans should assess adequate provider networks in the Medicaid program. MACPAC has periodically commented on these proposed rules, and most recently published a chapter on monitoring access in the March 2017 report to Congress.
This presentation provided background on the current monitoring systems in place, including Centers for Medicare & Medicaid Services (CMS) rules for monitoring access in fee for service (FFS) and managed care, and challenges with the existing approach. It concluded with the Commission’s plan for the year.