On November 14, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule amending several sections of the comprehensive 2016 Medicaid managed care oversight regulation. Specifically, the proposed changes would modify current rules affecting rate-setting, directed payments, pass-through payments, network adequacy standards, state quality rating systems, beneficiary information requirements, grievance and appeals requirements, and the requirements that apply to the State Children’s Health Insurance Program (CHIP).
This presentation provides background on the current rule, summarizes the proposed changes, and highlights areas where the Commission could provide comments.