Capitol Correspondence - 09.03.19

Still Time to Weigh in on Medicaid Access Rule Changes

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As previously shared with ANCOR’s Government Relations Committee, we are seeking individuals to weigh in on CMS’ changes to the Medicaid Access Rule. See below for more information and email [email protected] with the subject line “Add me to Access Group” to get involved.

We are seeking ANCOR member volunteers to help us frame our input to the Notice of Proposed Rulemaking (NPRM) to rescind the Obama Administration’s 2015 regulations on the access rule and develop a new strategy to measure and monitor beneficiary access. This is an exciting opportunity to weigh in with CMS on how to measure the value of our services, remind them of our low reimbursement rates, and promote ideas on how to better assure quality service delivery. See below for more details and how to get involved!

Brief background: The access requirement of the Social Security/Medicaid statute is very important – it requires accountability in the program to be able to provide sufficient access to the program for individuals served (e.g. think adequate provider rates, etc.). ANCOR has had a long history working on this issue first prompting the Obama Administration to include HCBS services in their rulemaking (ultimately in 2015 CMS ended up limiting rules on access and requirements to state accountability to very limited medical services). We then held a bipartisan Congressional briefing and met with the Director of CMS and her staff several times – even producing a whitepaper on how to measure accountability in HCBS services. We have come very far in this conversation but we were aware that the Trump Administration began its term wanting to respond to states’ concerns about the administrative burden of documenting accountability and they thus just proposed rescinding the 2015 limited Obama requirements this summer.

Because of our involvement in this issue CMS contacted ANCOR directly  to alert us to the rescission but also to notify us that they would like feedback from ANCOR on initiating a new strategy to measure and monitor beneficiary access to care across Medicaid and how to include HCBS in those conversations.

More background from CMS with proposed rule changes and statement from Acting Director of CMS, Calder Lynch: 

The Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking to rescind outdated 2015 requirements that impose complex administrative burdens on States without meaningful impact to beneficiaries.  This effort  will streamline federal oversight of access to care requirements that protect to Medicaid beneficiaries.

CMS is also issuing guidance to states to remind them of their ongoing statutory responsibilities to ensure appropriate access to care for beneficiaries.