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CMS Issues Notice of Requirements for Changes to Medicaid Rates

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CMS Issues Notice of Requirements for Changes to Medicaid Rates

July 1, 2016
On June 24, the Center for Medicare & Medicaid Services (CMS) released an Informational Bulletin to summarize procedures states must follow when making changes to provider payments under the Medicaid state plan and to emphasize the importance of public notice content and timing requirements. Specific to payment changes, there are three types of procedures: 1) public notice policies that pertain to all proposed changes to provider payment rates or methodologies; 2) public input process policies, which apply when states reduce rates or restructure payments, and are designed to obtain input related access to care and; 3) public input process policies that are specific to changes to institutional provider payment rates.
 
The notice clarifies and reminds states of requirements set forth by various authorities, including the recently-finalized Medicaid Access rule (see WICs article, "ANCOR Analysis of Medicaid Access Rule Available," November 16, 2015). Broadly, the rule requires notice and the opportunity for public input when a state makes certain changes to Medicaid rates that will impact beneficiary access to services under a state plan.