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Advocates split with health plans and states over Medicaid long-term care rules
Modern Healthcare

Patient advocates are praising a section of the CMS‘ proposed Medicaid managed-care rule related to long-term care. But health plans and states are sharply critical of provisions imposing new credentialing requirements on long-term care providers and allowing beneficiaries to opt out of managed care if their provider is not in a health plan’s network.The CMS included in the proposed rules a provision requested by patient advocates that allows beneficiaries enrolled in managed long-term care services and supports to switch plans or switch to fee-for-service Medicaid if their provider is out of network.

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