CMS releases final Medicaid, CHIP rule: 4 things to know


CMS issued its 2020 Medicaid and Children's Health Insurance Program Managed Care final rule Nov. 9.

Four things to know:

1. The rule aims to loosen Medicaid managed care requirements that were imposed in 2016 that many stakeholders said were too burdensome. 

2. Under the rule, states will be able to complete federal rate review processes quicker, while still meeting their requirement to implement a quality rating system for managed care plans they contract with.

3. The rule also changes the minimum standards states must use in creating network adequacy requirements to allow for more telehealth options.

4. Fifty-five million beneficiaries are enrolled in managed Medicaid care plans. This figure includes the 79 percent of CHIP members in 32 states who are enrolled in managed care plans.

View the full rule here.

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