On November 22nd, HHS issued a proposed rule that would make changes to the Medicaid and CHIP Managed Care final rule published on May 6, 2016. The final rule required states to start phasing out pass-through provider payments beginning July 1, 2017. Since the release of the final rule, some states have contacted CMS about increasing or adding new pass-through provider payments under their managed care contracts that could run contrary to CMS’ goals in the final rule. This proposed rule would prohibit states from increasing pass-through provider payments under Managed Care in the intervening time before the July 1, 2017 phase-out date in the final rule. HHS will accept comments until December 22, 2016.
Please find attached a summary of the proposed rule. The full rule is available here.