CMS plans Medicaid 'red-tape' rollback for states

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The agency said proposed changes to access monitoring requirements would save more than $1.6 million. (Sarah Stierch)

States could see less administrative burdens in the near future thanks to a proposed regulatory rollback by the Medicaid agency.

The Centers for Medicare & Medicaid Services (CMS) Thursday proposed additional flexibility and exemptions for states from certain Medicaid paperwork requirements, including the submission of access monitoring review plans and data analysis.

The agency said states have raised concerns about the administrative burden associated with requirements of the 2015 rule "Methods for Assuring Access to Covered Medicaid Services," particularly states with high rates of Medicaid managed care enrollment. States have urged the agency to consider whether access monitoring is a beneficial use of state resources, especially for those with few Medicaid members enrolled in fee-for-services programs.

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Proposed changes include:

  • Exemptions from most access monitoring requirements for the 17 states with an overall Medicaid managed care penetration rate of 85% or greater.

  • Reductions to provider payments of less than 4% percent in overall service category spending during a state fiscal year, and 6% over two consecutive years would not be subject to the specific access analysis.

  • When states reduce Medicaid payment rates, they would rely on baseline information regarding access under current payment rates.

RELATED: CMS’ Verma announces new meaningful measures initiative

The agency said the proposed changes would reduce state administrative burden by 561 hours and reap a total savings of over $1.6 million.

CMS Administrator Seema Verma said the proposal is in line with President Donald Trump's commitment to reducing regulatory burdens, and is part of a series of initiatives to help providers and states focus more time on patient outcomes instead of paperwork.

“Today’s proposed rule builds on our commitment to strengthening the Medicaid program and assist those it serves through state partnerships that improve quality, enhance accessibility and achieve outcomes in the most cost effective manner,” Verma said in an accompanying statement. “These new policies do not mean that we aren’t interested in beneficiary access, but are intended to relieve unnecessary regulatory burden on states, avoid increasing administrative costs for taxpayers, and refocus time and resources on improving the health outcomes of Medicaid beneficiaries.”

RELATED: CMS’ Kate Goodrich pegs 2018 as a ‘significant year’ for burden reduction, touts an ‘API-first strategy’

CMS has already taken steps in the last year to cut industry red tape.

In early 2018, Verma announced the "Patients over Paperwork" initiative, which created an internal process to evaluate and streamline regulations to reduce unnecessary burden. In October the agency rolled out another initiative to streamline quality measures.

The CMS has also said more regulatory relief is coming down the pipe in 2018. Kate Goodrich, CMS' Chief Medical Officer, said last month that “2018 is going to be a significant year in terms of regulatory and burden reduction."

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