CMS Rule Would Monitor Medicaid Access

The Centers for Medicare and Medicaid Services has transmitted to the Office of Management and Budget a proposed rule requiring new reporting procedures for state Medicaid agencies to ensure they are providing appropriate access to care.


The Centers for Medicare and Medicaid Services has transmitted to the Office of Management and Budget a proposed rule requiring new reporting procedures for state Medicaid agencies to ensure they are providing appropriate access to care.

OMB review is one of the last steps before a rule is officially published in the Federal Register. Generally, a listing on OMB's Review Site means a rule can be expected soon. But some health related rules on the site have sat there for eight or nine months.

"The Medicaid statute requires that state plans provide sufficient procedures and methods to ensure that payment rates for Medicaid services are sufficient to enlist qualified providers to ensure that care and services are available to Medicaid beneficiaries at least to the extent that care and services are available to the general public in the same geographic area," according to brief description of the newly listed rule. "This proposed rule seeks to clarify the definition of access to care and services and provide standard data elements and measures that states must submit to CMS to demonstrate that payment rates are sufficient to provide access to covered Medicaid services."

--Joseph Goedert