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Response to CMS RFI on Access and Coverage in Medicaid and CHIP

In a letter to the Centers for Medicare & Medicaid Services (CMS) responding to a request for information on access to coverage and care in Medicaid and the State Children’s Health Insurance Program (CHIP), MACPAC provided feedback on a wide range of access-related topics, including enrolling in and maintaining coverage, accessing services, and ensuring adequate payment rates. In particular, the Commission recently approved a number of recommendations for improving the system for monitoring access to care for Medicaid beneficiaries; these recommendations will appear in our forthcoming June report.

The letter encourages CMS to draw on MACPAC’s prior research showing that efforts at simplification, including using electronic data sources and automating processes, can lead to administrative savings and streamlined procedures for both states and beneficiaries. MACPAC wrote that CMS should focus on several key areas, including the upcoming unwinding of the continuous coverage requirements at the end of the public health emergency. CMS should continue encouraging states to use available options, such as adoption of 12-month continuous eligibility, and modes of communication that are supported by research and meet the needs of beneficiaries.

In addition, the letter highlighted the need for state and federal officials to have timely and consistent information on the extent to which beneficiaries can access services and encouraged CMS to establish consistent and comparable measures that can be used across delivery systems and states. Finally, the letter encourages CMS to consider the feasibility and appropriateness of establishing minimum payment standards for particular services, such as vaccines, as part of its efforts to improve access, and to consider ways to streamline provider enrollment processes to ease administrative burden and promote participation.