The new Medicaid Managed Care Final Rule (Final Rule), recently released by the Centers for Medicare and Medicaid Services (CMS), makes significant changes to state directed payments. The provisions in the Final Rule aim to enhance transparency and consistency in payments to managed care organizations, while also giving states greater flexibility in designing payment methodologies. An important addition to the Final Rule, the Informational Bulletin, provides significant enforcement discretion alongside these financing provisions. The Final Rule will significantly alter state financing of Medicaid managed care plans. Whether the states will receive the necessary funding and support from their legislatures to implement these changes is unknown.

Read the full article, “Medicaid Managed Care Final Rule: Long-awaited pronouncement on permitted uses of state directed payments.”