Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)
Revision of a currently approved collection
No
Regular
Comment filed on proposed rule and continue
09/16/2019
08/30/2019
Prior to publication of the final rule, the agency shall provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
04/30/2022
36 Months From Approved
01/31/2023
202
0
202
23,898
0
23,898
0
0
0
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.
Our July 15, 2019 (84 FR 33722) NPRM (CMS-2406-P2, RIN 0938-AT41) proposes to remove the regulatory text that sets forth the current required process for states to document whether Medicaid payments in fee-for-service systems are sufficient to enlist enough providers to assure beneficiary access to covered care and services consistent with the Medicaid statute. As a result we are proposing to discontinue all of the requirements that are currently approved under this control number and zero out such burden.
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 (NPRM version 2).docx
Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))