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Skilled care providers were reacting with caution to proposed “significant” changes to private Medicaid plans that federal officials say will lessen regulatory burdens and give states more flexibility.

Centers for Medicare & Medicaid officials said their goal is to pass a slew of proposed changes that 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 a CMS announcement.

The proposed rule presents “both opportunities and challenges for long-term care,” said Narda Ipakchi, senior director of managed markets for the American Health Care Association. “We appreciate that CMS recognizes the importance of supplemental payments and will allow states to utilize them at implementation,” she said.

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.

CMS is accepting comments on the proposed rule until Jan. 14, 2019. More information is available in its fact sheet.