CMS Releases Informational Bulletin on 2016 Medicaid Managed Care Rate Development GuideImage Banner

CMS Releases Informational Bulletin on 2016 Medicaid Managed Care Rate Development Guide

You are here

CMS Releases Informational Bulletin on 2016 Medicaid Managed Care Rate Development Guide

July 7, 2016

On July 1, the Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin that discusses provisions of final rule CMS-2390-F, 81FR 27498. (See WICs article, "Medicaid Managed Care Final Rule Released", April 28, 2016.) This rule aligns Medicaid managed care with other major sources of coverage, implements statutory provisions, strengthens actuarial soundness payment provisions to promote accountability of Medicaid managed care program rates, and contains several beneficiary protection provisions. The new Informational Bulletin provides information for states that are developing rates to assure that states understand their compliance obligations. CMS says that for states that have already approved rates for 2016 or that completed their rate development process prior to the final rule, it will use its enforcement discretion to provide states with a reasonable opportunity to come into compliance.