The Centers for Medicare and Medicaid Services (CMS) published guidance on the Ensuring Access to Medicaid Services final rule. This guide focuses on documentation of access to care and service payment rates, which is specific to fee-for-service delivery systems and rates. These requirements replace the access monitoring review plans, which were rescinded in the final rule.
The guidance reviews the scope, publication requirements, and sample documentation for payment rate transparency publication, the comparative payment rate analysis, and payment rate disclosure. It also discusses the scope, general requirements, and templates for state analysis procedures for rate reduction or restructuring.
Requirements for payment rate transparency publication, comparative payment rate analysis publication, and payment rate disclosure apply beginning July 1, 2026.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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