New rules help enhance care, quality, and equity for Medicaid managed care program enrollees

04.24.2024/Statement

New rules help enhance care, quality, and equity for Medicaid managed care program enrollees

WASHINGTON, D.C.- Yael Lehmann, Interim Executive Director of Families USA, issued the following statement on final rules released this week, Ensuring Access to Medicaid Servicesand Medicaid and Children's Health Insurance Program Managed Care Access, Finance, and Quality. Together, theserules will help improve health care access, quality, and equity for Medicaid and Children's Health Insurance Program (CHIP) beneficiaries enrolled in traditional Medicaid and Medicaid managed care programs.

"Just weeks afterthe Biden-Harris Administration released a final rulestreamlining Medicaid and CHIP enrollment, they've continued their commitment to strengthening the care provided to the millions of families and children who rely on these programs for their health care.

"Several changes in these rules will helpincrease oversight, access, and transparency, and improve health outcomes for people who rely on Medicaid for their health care. . Specifically, Families USA applauds establishing maximum appointment wait time standards, incorporating more meaningful data, requiring full transparency around state directed payments to hospitals,, and requiring that 80% of Medicaid payments to home and community-based services companies are spent on compensation for direct care versus administrative overhead or profit.

"We commend the Biden-Harris administration's implementation of these significant improvements to ensureeligible children and families who rely on Medicaid and CHIP for their health care have the peace of mind that access to health coverage provides.

"But much more can and should be done.Moving forward, we'll continue pushing for policies that build on these positive developments by advocating for the inclusion of appointment wait time standards for time-sensitive reproductive health services, including abortion; increasing transparency around Medicaid reimbursement rates; and requiring states with a fee-for-service Medicaid system to demonstrate that they adhere to the same timeliness standards as required of states with Medicaid managed care organizations."

###

Families USA, a leading national voice for health care consumers, is dedicated to the achievement of high quality, affordable health care and improved health for all.