The Health and Human Services (HHS) Agency issued a new semi-annual regulatory agenda item specifying its intent to undertake further rulemaking to impose additional conditions on Medicaid Managed Care Directed Payments. HHS cited integrity of federal funding as the basis […]
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 schedules based […]
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 directed payments based […]
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 2016 managed […]
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 […]
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 […]
On Nov. 10, 2016, CMS issued its first set of Frequently Asked Questions on the Medicaid Managed Care Final Rule published in May. For more information on the Final Rule and the latest explanatory guidance, see our Medicaid Managed Care Resources […]
Oct. 27, 2016: CMS has issued its Medicaid Managed Care Rate Development Guide for rating periods starting between January 1, 2017 and June 30, 2017. A number of critical provisions from the new regulations, including provisions related to special contract […]
Oct. 19, 2016: CMS submitted to the Office of Management and Budget for review a proposed rule that would presumably limit the ability of states to create new or increased pass-through payments to providers in their Medicaid managed care programs. […]
July 29, 2016: CMS releases guidance on Pass-Through Payments in Medicaid Managed Care
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