Insurers back CMS proposal to relax network adequacy rules for state Medicaid managed care programs

Insurers voiced their support Monday for a Centers for Medicare & Medicaid Services proposal that would allow states more flexibility in determining the network adequacy of their Medicaid managed care providers. But they raised concerns about changes in that proposal that would make technical changes in federal rate setting standards they said could be inconsistent with actuarial soundness requirements and ultimately result in Medicaid managed care plans having inadequate resources. Their comments came in response to a proposed rule (PDF) from CMS Administrator Seema Verma to update a 2016 regulation, giving states more control over setting rates for capitated payments and providing a three-year transition period for pass-through payments to shift providers from fee-for-service to managed care.