Medicaid Alert: New Managed Care Rule — Action Required by July 2024
New Medicaid managed care rule effective July 9, 2024, requires compliance actions.
Action required by
July 9, 2024
Review the Action Required section below and ensure your team has completed all compliance steps before this date.
The recent Federal Register Final Rule (Policy ID: FR-2024-08085) introduces significant changes to the Medicaid and Children's Health Insurance Program (CHIP) managed care framework, effective July 9, 2024. The rule aims to enhance access to care and improve health equity for Medicaid beneficiaries.
What Changed Key changes include requirements for managed care organizations (MCOs) to implement strategies that promote equitable access to services, particularly for underserved populations. MCOs must establish performance metrics to ensure compliance with these new access and equity standards. While specific CPT, HCPCS, or ICD-10 codes affected by this rule are not detailed, the rule may influence coding and billing processes by streamlining reimbursement timelines and altering service billing under Medicaid and CHIP managed care plans.
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Quick answers
What are the key changes in the new Medicaid rule?
The rule requires MCOs to implement strategies for equitable access and establish performance metrics.
How will this affect coding practices?
Coders must review and adjust practices to align with new access and equity standards.
What is the compliance deadline for these changes?
The compliance deadline is set for July 9, 2024.
Content summarized from publicly available federal publications including CMS, MAC contractors, and the Federal Register. CLV Intelligence is not affiliated with or endorsed by any government agency. This is not legal or medical advice.