May 3, 2023 – The Biden-Harris Administration announced they are taking some significant steps to improve access, transparency, and the quality of healthcare services for Medicaid and CHIP beneficiaries. The Centers for Medicare & Medicaid Services (CMS) recently proposed new rules that are all about making positive changes in the world of managed care.

These new proposals come in response to the rapidly changing landscape of healthcare delivery and payment systems. As our society evolves, so does the need for better access to quality healthcare services, especially for those enrolled in Medicaid managed care and CHIP.

One of the most significant aspects of the proposed rules is their focus on enhancing transparency. They aim to make it easier for beneficiaries to access vital information about the healthcare providers and services available to them. The proposed rules include new standards for the accessibility of information, such as provider directories and formularies.  

The proposal also includes provisions to ensure that managed care plans offer a more comprehensive network of providers. This means that beneficiaries will have better access to the care they need when they need it. The new rules will also require managed care plans to maintain an up-to-date list of in-network providers, ensuring that beneficiaries can easily find a provider who meets their needs. 

In addition to enhancing transparency and access, the proposed rules also focus on improving the overall quality of healthcare services. They include provisions that promote the use of evidence-based practices and support quality improvement initiatives. These measures will help ensure that beneficiaries receive the best possible care.

The Biden-Harris Administration is all about promoting collaboration and innovation, and these proposed rules are no exception. They encourage state Medicaid agencies, managed care plans, and healthcare providers to work together in the best interest of Medicaid and CHIP beneficiaries. 

The CMS proposal is a game-changer in the managed care space, seeking to improve transparency, access, and quality for Medicaid and CHIP beneficiaries. It’s a bold move that could positively impact the lives of millions of people across the nation. 

To read the full press release from HHS, click here.