Earlier today, April 25, 2016, the Centers for Medicare and Medicaid Services (CMS) issued the Medicaid and CHIP Managed Care final rule (Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions related to Third Party Liability - CMS-2390-F).  Under development for the past year, the final regulation modernizes and updates Federal requirements for Medicaid managed care programs.  In particular, the rule sets new expectations for managed long-term services and supports (MLTSS) programs.  ADvancing States appreciates CMS’ acknowledgement of the increasing importance of managed care delivery systems in providing Medicaid services to older adults and persons with disabilities, and recognize that setting minimum expectations for managed LTSS programs will serve the Medicaid program well.

ADvancing States is currently in the process of analyzing the regulation, and we will distribute additional information as it becomes available.  In the interim, we encourage you to view the final rule, which is available here until its publication in the May 6 Federal Register. 

CMS has also released several resources on the new rule, which are accessible on ADvancing States’s website via the following links:

• Improved Alignment with Medicare Advantage and Private Coverage Plans
• Strengthening Managed Care in CHIP
• Strengthening the Consumer Experience
• Strengthening States’ Delivery System Reform Efforts
• Strengthening Program and Fiscal Integrity and Accountability
• Strengthening the Delivery of Managed Long Term Services and Support
• Modernizing Medicaid and CHIP Managed Care
• Improving the Quality of Care for Medicaid Beneficiaries
• Implementation Dates