Public Inspection: CMS: Medicaid Program: Medicaid and Children's Health Insurance Program Managed Care Access, Finance, and Quality

Federal Register

Apr 23, 2024

Pre-publication notice of final rule from the Centers for Medicare & Medicaid Services (CMS) advancing CMS' efforts to improve access to care, quality and health outcomes, and better address health equity issues for Medicaid and Children's Health Insurance Program (CHIP) managed care enrollees. This rule specifically addresses standards for timely access to care and States' monitoring and enforcement efforts, reduces burden for some State directed payments and certain quality reporting requirements, adds new standards that will apply when States use in lieu of services and settings (ILOSs) to promote effective utilization and specify the scope and nature of ILOS, specifies medical loss ratio (MLR) requirements, and establishes a quality rating system for Medicaid and CHIP managed care plans. These regulations are effective July 9, 2024.

Access · Health insurance · Healthcare business and finance · Healthcare quality · Legislation and regulations · Medicaid