CMS has issued a proposed rule that will create a "standardized, transparent process" for states when they set Medicaid reimbursement rates and help ensure access, according to an AHA News Now report.
The intent of the proposed rule is to protect access while allowing states to adjust rates and experiment with new delivery models. Under the rule, states must adopt an ongoing process to monitor Medicaid beneficiaries' access to healthcare service by service type.
According to the proposed rule, states with proposed reimbursement cuts would need to review the new rates compared to:
• Usual and customary charges;
• Medicare payments, commercial payments or Medicaid costs;
• The composite average reduction from proposed rate changes.
Read the AHA News Now report on Medicaid rate setting.
Read related articles on Medicaid:
CMS Won't Let Florida Privatize Medicaid Program for Now
HHS Approves First Planned Arizona Medicaid Cut
Hospitals, Practices Wary of Move to Medicaid Managed Care
The intent of the proposed rule is to protect access while allowing states to adjust rates and experiment with new delivery models. Under the rule, states must adopt an ongoing process to monitor Medicaid beneficiaries' access to healthcare service by service type.
According to the proposed rule, states with proposed reimbursement cuts would need to review the new rates compared to:
• Usual and customary charges;
• Medicare payments, commercial payments or Medicaid costs;
• The composite average reduction from proposed rate changes.
Read the AHA News Now report on Medicaid rate setting.
Read related articles on Medicaid:
CMS Won't Let Florida Privatize Medicaid Program for Now
HHS Approves First Planned Arizona Medicaid Cut
Hospitals, Practices Wary of Move to Medicaid Managed Care