The Centers for Medicare & Medicaid Services had formed a new entity, the Managed Care Group, to oversee Medicaid managed care policy, assist with Section 1115 demonstration waivers, and review and approve state plan amendments for the Program of All-Inclusive Care For the Elderly (PACE).
In a notice in the Federal Register published Monday, CMS said the Managed Care Group, which will reside in the Center for Medicaid and CHIP Services, “provides national leadership in the development and management of Medicaid program policy and operations regarding managed care programs and provides technical assistance to States and other stakeholders.”
The Managed Care Group also establishes Medicaid program policy around access, and accountability for all managed care programs, including for people who need long-term services and supports, according to the Federal Register.
Among its other functions, according to the Federal Register notice:
- Provides subject matter expertise and technical support in the review of managed care in Section 1115 demonstrations.
- Establishes and reviews policy and performs operations related to 1915(b) “freedom of choice” waivers.
- Reviews and approves state plan amendments for PACE.
The creation of the Managed Care Group comes after CMS in late April proposed two pivotal rules expanding access to Medicaid. One of them, Ensuring Access to Medicaid Services (Access NPRM), contains a controversial measure that would require that at least 80% of Medicaid payments for personal care, homemaker and home health aide services be spent on compensation for direct care workers.
Access NPRM also would require states to report on waiting lists in section 1915(c) waiver programs; service delivery timeliness for personal care, homemaker and home health aide services; and a standardized set of home-and-community-based services quality measures.
Last week, the National Association for Home Care & Hospice and the Partnership for Medicaid Home-Based Care requested a 60-day extension on the comment period for the Access NPRM proposed rule.
Monday’s Federal Register notice also revealed that the Disabled and Elderly Health Programs Group will be renamed the Medicaid Benefits and Health Programs Group within the Center for Medicaid and CHIP Services.