Medicaid Program; The Use of New or Increased Pass-Through Payments in Medicaid Managed Care Delivery Systems
SUMMARY: This rule finalizes changes to the pass-through payment transition periods and the maximum amount of pass-through payments permitted annually during the transition periods under
DATES: Effective Date: These regulations are effective on
FOR FURTHER INFORMATION CONTACT:
SUPPLEMENTARY INFORMATION:
I. Background
In the
In the
In the
A. Summary of the Medicaid Managed Care
We finalized a policy to limit state direction of payments, including pass-through payments, at
In an effort to provide a smooth transition for network providers, to support access for the beneficiaries they serve, and to provide states and managed care plans with adequate time to design and implement payment systems that link provider reimbursement with services covered under the contract or associated quality outcomes, we finalized transition periods related to pass-through payments for the specified provider types to which states make most pass-through payments under
As finalized in the
We believe that states will be able to more easily transition existing pass-through payments to physicians and nursing facilities to payment structures linked to services covered under the contract compared to the transition necessary for similar payments to hospitals. Consequently, the
B. Questions About the
Since publication of the
FOOTNOTE 1 The Use of New or Increased Pass-Through Payments in Medicaid Managed Care Delivery Systems; available at https://www.medicaid.gov/federal-policy-guidance/downloads/cib072916.pdf. CMCS also noted in this CIB that it intended to further address in future rulemaking the issue of adding new or increased pass-through payments to managed care contracts. END FOOTNOTE
--This is a summary of a
Final rule.
CFR Part: "42 CFR Part 438"
RIN Number: "RIN 0938-AT10"
Citation: "82 FR 5415"
Document Number: "CMS-2402-F"
Federal Register Page Number: "5415"
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