CMS To Phase Out State Pass-Through Payments Made Via Medicaid Managed Care

On June 29, 2016, the Center for Medicare & Medicaid Services (CMS) informed states that it would not approve the use of new or larger pass through payments flowing through Medicaid managed care contracts because doing so would be contrary to the intent of the the final Medicaid managed care regulations, released April 25, 2016. The term “pass-through payments” refers to payments that states make to managed care organizations (MCOs) that are over and above the MCOs' capitated rates and that are intended to flow through the MCO directly to specific provider organizations without interference from the MCO. Many . . .