The federal government is proposing “significant” changes to private Medicaid plans that it hopes will relieve regulatory burdens and allow states more flexibility. Skilled care providers, however, say the changes aren’t all positive for the field.
Centers for Medicare & Medicaid officials noted Thursday that enrollment in Medicaid managed care has swelled in recent years. Their goal is to pass a slew of proposed changes that they say should remove barriers and give states more flexibility to set standards for the adequacy of healthcare networks.
“Targeted improvements to the managed care rule have been a top priority for Medicaid directors,” Judy Mohr Peterson, board president of the National Association of Medicaid Directors said in the CMS announcement. “NAMD appreciates the partnership shown by CMS to explore these issues and dialogue with the states.”
The proposed rule presents “both opportunities and challenges for long-term care,” according to Narda Ipakchi, senior director of managed markets for the American Health Care Association. It pushes to promote state and plan flexibility, and incentivize a continued transition away from fee-for-service medicine and toward managed care. “We appreciate that CMS recognizes the importance of supplemental payments and will allow states to utilize them at implementation,” she added.
However, one challenge is CMS’ proposed elimination of time and distance network adequacy standards for provider networks, including those who deliver long-term services and supports.
“While time and distance requirements, on their own, are not adequate indicators of access, they provide a minimum threshold which states and plans can build upon to address the unique access needs for the LTSS population,” Ipakchi told McKnight’s.
CMS is accepting comments on the proposed rule until Jan. 14, 2019. More information is available in its fact sheet.