The Centers for Medicare & Medicaid Services (CMS) has issued a final rule on Medicaid access.
The American Association for Homecare (AAHomecare) discussed the Ensuring Access to Medicaid Services final rule in an April 24 bulletin, stating, “One of the biggest changes in this final rule are updates to documentation related to access to care and service payment rates.
“This rule requires that the Medicaid FFS [fee for service] payment rates are available on a website that is accessible to the general public and must include the last date the payment rates were updated. This will improve transparency in states that have not updated DME [durable medical equipment] fee schedules in several years.”
As part of the final rule, Medicaid programs will be required to keep their payment information regularly updated, the AAHomecare announcement added.
“The states must ensure that any rate updates based on previously approved state plan amendments must be updated no later than one month after the effective date of the most recent change,” the association said. “This would require states that follow Medicare rates to update their fee schedules on a quarterly basis. The Payer Relations Council will be reviewing this provision in detail at the next Council meeting and assessing the potential impact to HME [home medical equipment] suppliers.”
Giving Medicaid beneficiaries and families more power
The new final rule also gives Medicaid beneficiaries and their families more input regarding their states’ Medicaid programs.
“The rule also improves and expands the scope of the Medical Care Advisory Committees in the states,” AAHomecare said. “It requires states to develop a beneficiary advisory council (BAC) comprised of Medicaid beneficiaries and their family members. The Medical Care Advisory Committee will be required to have 25% of their members from the BAC. This will allow for more beneficiary input into the state Medicaid programs, which should help our advocacy efforts.”
“CMS has actively sought to improve access to care and services for the people enrolled in the Medicaid program, but has been limited by outdated regulations that need to be more comprehensive and consistent across all delivery systems and coverage authorities,” the agency said in an April 22 fact sheet it provided about the new final rule. “The Access rule addresses critical dimensions of access across both Medicaid FFS and managed care delivery systems, including for HCBS [home- and community-based services].
“These improvements seek to increase transparency and accountability, standardize data and monitoring, and create opportunities for states to promote active beneficiary engagement in their Medicaid programs with the goal of improving holistic access to care.”
