Proposed Rules on Medicaid Payments, Access and Quality: Implications for Health Care Stakeholders

On Thursday, April 27, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated proposed rules (here and here). Together, these would reshape the federal regulatory landscape for Medicaid and the Children’s Health Insurance Program (CHIP), particularly with respect to standards for ensuring access to care, transparency and oversight of provider payment rates, engagement of Medicaid enrollees and the public, quality measurement, and program accountability.

In a new webinar, Manatt Health will review some of CMS’s key proposals and discuss the implications for stakeholders, including Medicaid and CHIP beneficiaries, health care providers, state Medicaid agencies, and Medicaid managed care plans. The webinar will include discussion of CMS’s proposals to:

  • Modify the guardrails and areas of state flexibility regarding state directed payments (SDPs), a mechanism that states can use to establish parameters for managed care plans’ payments to providers
  • Enhance transparency regarding provider rates and require the publication of comparative rate analyses for certain services, in both the fee-for-service (FFS) and managed care delivery systems
  • Strengthen the framework for monitoring access to care
  • Establish new requirements and processes regarding quality standards and performance measurement for managed care plans

Note: CMS’s proposed rules also include a number of proposals aimed at enhancing access and quality for home and community-based services (HCBS). Manatt discussed those proposals in a separate webinar. If you missed our session on “Proposed Rules to Enhance Access and Quality for Medicaid HCBS and Strengthen the HCBS Workforce,” click here to view the program for free on demand.


Date and Time:

Tuesday, June 20

If you would like to receive an audio transcript of this webinar due to accessibility issues, please email us at

This program does not constitute legal advice, nor does it establish an attorney-client relationship. Views expressed by presenters are strictly their own and should not be construed to be the views of Manatt or attributed to Manatt.



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