CMS Nears Finalization of Medicaid Access Rule Amidst Debated 80/20 Provision
CMS Nears Finalization of Medicaid Access Rule Amidst Debated 80/20 Provision
On January 26, 2024, the Centers for Medicare & Medicaid Services (CMS) submitted the final Ensuring Access to Medicaid Services (CMS-2442) rule to the Office of Management and Budget (OMB) for the last review stage. The final clearance process, potentially spanning weeks or months, may lead to a spring release, with an estimated projection for April 2024.
The proposed rule introduces the debated 80/20 provision, mandating that 80% of Medicaid payments for specific services be allocated to direct care worker compensation. Last summer, HCAF raised concerns in comments to CMS, highlighting issues with CMS' one-size-fits-all approach that overlooks the distinct challenges faced by different states. HCAF advocated for changes, emphasizing potential unintended consequences that could impede access to care, leaving providers in a financial deficit or prompting withdrawal from the program.
Stay tuned for further details and announcements as updates are released.
Related News:
- Controversial 80/20 Medicaid Provision Looms as OMB Receives Proposed Rule (McKnights Home Care, 1/30/24)
- In-Home Care Providers Await Updates on CMS Medicaid Proposal, Begin Preparing for 80/20 Rule (Home Health Care News, 1/23/24)