Feds Propose Rules To Improve Medicaid Managed Care Access, Finance & Quality
On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that affects Medicaid managed care organization (MCO) contracts for Medicaid and Children’s Health Insurance Program (CHIP) plans. The goal is to improve access to and the quality of care for Medicaid and CHIP beneficiaries through new network and access standards, enhanced program integrity standards for state directed payments, further specification to medical loss ratio (MLR) requirements, and clarifications on the scope of in-lieu-of services …
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