CMS Issues Major Medicaid Managed Care Proposed Rule
The Centers for Medicare and Medicaid Services (CMS) issued a major proposed rule that focuses on Medicaid managed care related to minimum operation standards, care delivery, quality of care, and more on June 1, 2015. As more and more states move their Medicaid programs into one form or another of managed care, this proposed rule is the most important issued by CMS in years. In addition, since the proposal also addresses Medicaid Managed Long Term Services and Supports (MLTSS), it is of significant interest to the home care community.
NAHC has long advocated for the institution of federal standards to govern states shifting from a traditional fee-for-services (FFS) approach in Medicaid to a managed care delivery model. As states increasingly shift MLTSS to managed care, the need for such standards has grown since managed care plans have limited experience in providing the type of services, particularly personal care, that are the mainstay of MLTSS.
The central feature of the MLTSS proposal is the codification of the ten (10) elements that CMS included in its 2013 guidance regarding MLTSS. NAHC had worked with both the diverse provider and beneficiary communities on the development of this “pro-homecare” guidance.
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