CMS Released Guidance on Access Rule

In 2015, the Centers for Medicare and Medicaid Services (CMS) released a rule documenting a transparent data-driven process for states to document whether Medicaid payments are sufficient to enlist providers to assure beneficiary access to covered care and services consistent with section 1902(a)(30)(A) of the Social Security Act (the Act).  Note that the rule does not apply to waiver services.

In line with the current Administration’s goal of providing greater state flexibility and reducing regulatory burden, CMS released guidance on November 16 on how states can interpret certain provisions of the rule and efforts that will be made to ease any regulatory burden. That guidance can be accessed here.