On April 27, the Centers for Medicare and Medicaid Services (CMS) released two Medicaid proposed rules. These proposed rules would establish national standards access to care regardless of whether care is provided through a managed care organization (MCO) or directly by states in fee-for-service (FFS).
The “Ensuring Access to Medicaid Services” proposed rule would change the Medical Care Advisory Committees (MCAC) structure and operations to support more meaningful and accessible engagement by all committee members with an emphasis on Medicaid beneficiaries. States would be required to establish and operate the newly named Medicaid Advisory Committee (MAC) and a Beneficiary Advisory Group (BAG). This proposed rule would establish minimum requirements for stakeholder representation on the MAC. The MAC would include representation from the BAG and other interested parties, such as consumer advocacy groups, clinical providers or administrators, Medicaid managed care plans, and other state agencies serving Medicaid beneficiaries.
The “Medicaid and Children's Health Insurance Program Managed Care Access, Finance, and Quality” proposed rule focuses on updating Medicaid Managed Care programs. This proposed rule would advance CMS’ efforts to improve access to care, quality and health outcomes, and better address health equity issues for managed care enrollees. Both rules allow for a 60-day comment period for the notice of proposed rulemaking.