CMS-2328-FC requires a transparent,
data-driven process for states to document that Medicaid
beneficiaries have access to services covered under the Medicaid
State plan to the extent that services are available to the general
population in a geographic area. To meet the requirements of the
final rule, states must conduct access review monitoring plans that
measure: the extent that enrollee needs are met, the availability
of care and qualified providers, service utilization and payment
rate comparisons. The reviews will be conducted every three years
for: primary care, physician specialists, behavorial health, and
pre and post natal obstetric services (including labor and
delivery). As states reduce or restructure provider payment rates
or receive significant numbers of complaints from providers and
beneficiaires about access to care, additional services must be
included in the review plan and monitored for at least 3 years. We
are soliciting comments on the services required for ongoing access
reviews and the timelines associated with review and monitoring
activities. The final rule also requires states have mechanisms for
obtaining beneficiary and provider feedback on access to care, such
as hotlines, surveys, ombudsman or other equivalent mechanisms and
institute corrective action procedures should access issues be
discovered through the access review and monitoring processes.
Finally, when considering reductions to Medicaid payment rates the
final rule requires states to undertake a process that gathers
input from stakesholds and relies upon the information analyzed
through the data reveiws on the proposed reduction or restructuring
of Medicaid service payment rates.
Statute at
Large: 42
Stat. 1902 Name of Statute: null
As indicated in Supporting
Statement section 15, this 2018/2019 information collection request
makes a number of burden adjustments which remove completed
one-time requirements (see Change #1) and changes several estimates
based on current data (see Change #2, 3, and 4). Altogether, we
propose to reduce our currently approved burden estimates by minus
6,603 hours.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
CMS-10391 - Supporting Statement A (version 4).docx
Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))