CHA News Article

CMS Issues Guide to Medicaid, CHIP Managed Care Final Rule Implementation Dates

The Centers for Medicare & Medicaid Services (CMS) has issued the attached reference guide to the implementation dates for provisions in the Medicaid and the Children’s Health Insurance Program (CHIP) final rule. The rule, which is the first overhaul of Medicaid and CHIP managed care regulations in more than a decade, is designed to align the programs’ key rules with those of other health coverage programs, including qualified health plans and Medicare Advantage plans; to support state delivery system reform efforts; to strengthen the consumer experience and key consumer protections; and to strengthen program integrity by improving accountability and transparency.

The provisions of the rule will be implemented in phases over the next three years, starting July 1, 2017. CMS has tied some implementation dates to the rating period — the 12-month period for which capitation rates are developed under a managed care contract — to address states that have multi-year managed care contracts.

CHA is analyzing the final rule and its impact on hospitals, and will address the rule at the CHA Hospital Finance and Reimbursement seminars on June 15 in Sacramento, June 22 in Costa Mesa and June 23 in Pasadena.