Dive Brief:
- The Centers for Medicare & Medicaid Services (CMS) announced a final rule last week it says improves the agency's ability to measure and ensure meaningful access to covered services for beneficiaries who might otherwise face difficulty obtaining services.
- The agency says the intent of the rule is to help it make data-driven decisions that will help support more effective service delivery systems, rate structures, and provider payment methodologies.
- The rule was built upon comments submitted for the 2011 proposed rule, CMS says.
Dive Insight:
The rule not only protects beneficiaries, but improves CMS’ ability to "ensure Medicaid payment rates are consistent with efficiency, economy and quality and care," the agency's announcement notes.
It is based on three goals:
- Evaluating beneficiaries’ needs and use of services in connection with care and provider availability;
- Supporting the involvement of beneficiaries through feedback; and
- Supporting engagement of all stakeholders regarding proposed changes to Medicaid fee-for-service payments rates that could affect beneficiaries’ ability to access care.
In order to support those goals, the requirements of the final rule include that states must review and monitor beneficiaries' access to mandatory and optional services. The rule goes into effect January 4, 2016.