The Centers for Medicare and Medicaid Services (CMS) earlier this week released the Ensuring Access to Medicaid Services final rule. The rule supports ongoing initiatives to enhance health care accessibility and quality. It focuses on improving Home and Community-Based Services (HCBS) and enhancing transparency and public accountability. It also introduces additional data reporting and monitoring across Medicaid's fee-for-service and managed care systems.
Below are the key elements of the final rule, which will be published in the Federal Register on May 10, 2024, and take effect on July 9, 2024. A timeline for implementation of critical provisions is available here.
Please contact NCAL Director of Policy and Regulatory Affairs Jill Schewe with any questions.
Key Elements of the Final Rule
- Emphasis on Person-Centered Care: The rule stresses accountability, transparency, and the experiences of Medicaid beneficiaries in accessing care services.
- Establishment of Advisory Committees: State Medicaid Agencies are mandated to transition existing Medical Care Advisory Committees (MCACs) to a dual framework consisting of a Medicaid Advisory Committee (MEC) and a Beneficiary Advisory Council (BAC).
- Enhancement of Grievance and Incident Tracking: Requires creation of centralized systems for tracking grievances and incidents.
- HCBS Quality Measure Reporting: States must report on HCBS Quality Measure Sets, which include both mandatory and voluntary measures specified by CMS.
- Transparency in Web Resources: Development and maintenance of transparent web resources that include details on payment rates and reimbursement methodologies are required.
HCBS Payment Adequacy Standards
The final rule establishes HCBS Payment Adequacy standards, mandating that providers spend at least 80 percent of reimbursement for homemaker, home health aide, and personal care services on employee compensation.
States should collaborate with their State Medicaid Agency and applicable waiver administrative agencies to identify the impact this section of the rule may have on HCBS providers.