In this session, staff presented a draft chapter for the June report to Congress about the oversight of directed payments, a new option for states to require managed care plans to pay providers according to specified rates or methods.
The chapter includes a package of five recommendations related to:
- improving the transparency of existing directed payment approval documents, rate certifications, and evaluations;
- collecting new, provider-level data on directed payment spending;
- clarifying directed payment goals and their relationship to network adequacy requirements;
- providing guidance for more meaningful, multi-year assessments of directed payments, and;
- improving the coordination of reviews of directed payments and managed care rate setting.
