On May 3, 2023, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule in the Federal Register titled Medicaid Program: Medicaid and Children's Health Insurance Program Managed Care Access, Finance, and Quality (Proposed Rule). 88 Fed. Reg. 28092 (May 3, 2023). The Proposed Rule proposes to make significant changes to existing Medicaid managed care and Children’s Health Insurance Program (CHIP) regulations in a number of areas, including with respect to access requirements, requirements with respect to quality, and permissions regarding “in lieu of” services. Significant changes are proposed with respect to State directed payments, which have experienced substantial growth since being authorized by CMS in the 2016 Medicaid managed care overhaul.

In the linked memo, we review and summarize the major areas covered by the Proposed Rule, starting with the proposed changes to State directed payments. CMS requests comments in many areas, with comments due July 3. Dentons would be happy to assist you with preparation of comments in response to the Proposed Rule.

Download the memo