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Proposed Rule on Exemptions to Monitoring Access in Fee for Service

On March 23, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule amending a 2015 regulation specifying how states should comply with the Medicaid statute’s equal access provision: specifically, the process states must use to document whether provider payments in fee-for-service (FFS) Medicaid are sufficient to ensure enrollee access to services. The proposed rule would exempt states with high managed care enrollment and those making nominal payment changes.

This presentation provides background on monitoring access in FFS Medicaid, summarizes the proposed rule, and highlights areas where the Commission could provide comments.