NAPH Issues Statement in Support of CMS Regulation to Ensure Medicaid Access to Care - May 17, 2011

On May 11, NAPH issued a statement in support of the recent proposed rule issued by the federal Centers for Medicare & Medicaid Services (CMS), which will help ensure Medicaid patients have equal access to care. The rule, issued on April 29, would create a transparent process that states must follow to change Medicaid fee-for-service rates, as well as a requirement for ongoing state-level review of the impact of rates on access to services. These standards clarify compliance with Section 1902(a)(30)(A) of the Social Security Act, which requires state payments for Medicaid services to be “consistent with efficiency, economy, and quality of care and ... sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.”

The NAPH statement says: “For years, states have not been required to demonstrate that their Medicaid programs provide beneficiaries with . . . equal access. The CMS proposed regulation, drawing on the work of the congressionally-chartered Medicaid and CHIP Payment Access Commission, strikes an appropriate balance between enforcing the statutory requirement and providing states with flexibility to tailor their program to local needs and budgetary realities. We believe that the CMS action is a critical first step to protecting Medicaid patients’ access to care.” The full statement is available online.