CHA News Article

CMS Finalizes 2018 Proposed Rule for Medicaid Managed Care and CHIP
For CEOs, CFOs, finance & reimbursement staff, government relations executives

Earlier today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises Medicaid Managed Care and Children’s Health Insurance Program regulations intended to reduce state administrative burden and increase program flexibility. CHA provided written comments on CMS’ proposed rule in January 2019.

The final rule revises regulations for Medicaid managed care, including setting capitation rates, pass through payments, directed payments, network adequacy standards, risk sharing mechanisms, quality rating systems, appeals and grievances, and requirements for beneficiary information.

CHA is reviewing the final rule and will provide additional details in the coming weeks. More information on the changes being finalized is available in a CMS fact sheet.

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