Medicaid MCOs Have ‘Quite A Lift’ to Meet New Access, Quality Rules
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May 24, 2024
Medicaid managed care plans are going to invest significant money and time in making sure they comply with CMS’s recently released final rule pertaining to access, finance and quality, according to executives from consulting firm Sellers Dorsey who spoke during a May 20 webinar. Karen Brach, a Sellers Dorsey managing director and former health insurer executive, said “plans have quite a lift ahead of them,” although she added the rule presents a “tremendous opportunity for collaboration” among state Medicaid programs, plans and providers.
The final rule, which was published in the Federal Register on May 10, updates access and quality standards that were established in 2016 and 2020. It was released on the same day as another final rule addressing broader access issues, including requirements for home- and community-based services and fee-for-service Medicaid programs. Earlier this year, CMS announced a final rule on prior authorization and interoperability in Medicaid and a final rule on Medicaid eligibility and enrollment.
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