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CMS Releases New Medicaid Managed Care Rule FAQs

The Centers for Medicare & Medicaid Services (CMS) has released a set of frequently asked questions (FAQs) related to the Medicaid Managed Care rule finalised in April 2016.

The FAQs cover potential issues related to payments for patients in institutions for mental disease (IMD) within Medicaid managed care, including:

  • capitation payments for enrollees with a stay in an IMD;
  • changes to state plan amendments and waiver documents necessary to provide payment for a short-term stay in an IMD; and
  • clarification on the definition of short-term stays in an IMD.

CMS previous released a separate set of FAQs on the final rule in November 2016.

Contact Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.

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