AHA recommends certain changes to Medicaid/CHIP managed care rule

Commenting today on proposed revisions to the Medicaid and Children’s Health Insurance Program managed care regulations, AHA said it generally supports the Centers for Medicare & Medicaid Services’ efforts to grant greater state-level flexibility and reduce regulatory burden, but urged the agency to “strike the appropriate balance” between federal standards and state flexibility to ensure Medicaid enrollees have timely access to quality care services. For example, AHA recommends that CMS rescind its prohibition on fee-for-service supplemental payments in managed care contracts; reconsider proposed changes that could restrict provider payments in directed payment arrangements; and expand the proposed rule’s 15-day limit on care provided to eligible adult managed care enrollees in an institution for mental disease. The association also expressed concern that the proposed rule would weaken provider network adequacy standards.