CMS urged not to rescind Medicaid access monitoring plans

The AHA today urged the Centers for Medicare & Medicaid Services to withdraw its proposal to rescind a 2015 rule that requires states to develop and submit access monitoring review plans for certain Medicaid services. The requirement applies to primary care, physician specialists, behavioral health, pre- and post-natal obstetrics (including labor and delivery), and home health services.
 
“By removing this important oversight function, CMS’s proposal would put beneficiary access to care at greater risk,” AHA wrote. "While the AHA shares CMS’s goal of reducing the regulatory burden on the health care system, we believe that it is paramount that burden reduction efforts selectively target those burdens that are harmful, duplicative or provide no value. This proposed rule fails to meet this criteria. It would leave the Medicaid program without a regulatory structure and process for the states and CMS to assess the adequacy of payment rates to ensure beneficiary access.”
 
CMS has advised state Medicaid agencies that it plans to convene workgroups and technical expert panels that include stakeholders to examine the best approach to monitoring access. AHA recommended that CMS “move forward with this approach before making changes to the current regulatory structure,” calling it “essential” to include beneficiaries and providers in the process.