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CMS Releases New Guidance on Managed Care Directed Payments

Jan 8, 2021 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page

On January 8, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) outlining additional guidance on Medicaid managed care directed payments, as well as a revised preprint form for use in seeking approval of...

CMS Issues Medicaid Managed Care Final Rule

Nov 9, 2020 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates, Rulemaking

On November 9, 2020, CMS issued a managed care rule that largely finalizes policies proposed by the agency in a November 2018 proposed rule. Among other things, the final rule would eliminate prior approval requirements for directed payments implementing minimum fee...

CMS Released Proposed Medicaid Managed Care Rule

Nov 8, 2018 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates, Rulemaking

On November 8, 2018, CMS released proposed regulations to amend the 2016 Medicaid Managed Care Rule. The proposed rule would allow states to establish new 3-year pass-through payments for populations transitioning into managed care, streamline the approval process for...

CMS Releases Guidance on Direct Payments To Providers Under Managed Care

Nov 2, 2017 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates

CMS released additional guidance to states on development and approval of “directed payments”—payments that the state directs its managed care plans to make to identified classes of providers through their managed care contracts.  CMS newly defined this concept in its...

CMS Issues Final Rule Limiting New Pass-Through Payments

Feb 1, 2017 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates, Rulemaking

Just prior to the end of the Obama administration, on January 18, 2017, CMS published a final rule limiting the ability of states to create new or increased pass-through payments to providers in their Medicaid managed care programs. The rule’s effective date was...

CMS Issues Anticipated Pass-Through Payment Proposed Rule

Nov 18, 2016 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates, Rulemaking

CMS issues proposed rule that would limit the ability of states to create new or increased pass-through payments to providers in their Medicaid managed care programs. In its final Medicaid managed care rule issued last spring, CMS had explicitly allowed states to...
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