Proposed CMS Rule Addresses Medicaid Provider Rates

A proposed Medicaid rule would restrict the ability of states to cut Medicaid reimbursement rates for provider organizations and professionals. To reduce rates, states would be required to demonstrate that rate cuts would not impair access to care for Medicaid beneficiaries. States would also be required to continually monitor Medicaid recipients’ access to care and to measure and document access to every covered benefit at least once every five years. If a state were to find access issues, they would be required to develop plans to address those problems. The proposed rule does not apply to Medicaid managed care. The . . .