Access Rule

On July 12, 2024, CMS released a companion guide to the Ensuring Access to Medicaid Services (Access) Final Rule. This new resource provides guidance on the fee-for-service financial provisions of the Access Rule that relate to documentation of access to care and service payment rates. The guide is intended to help states understand when requirements apply to them and how to meet the requirements.

On April 22, 2024, CMS released a new set of final regulations related to ensuring access to Medicaid home and community-based services (HCBS). The regulations are collectively referred to as the Access Rule. The Access Rule adds new requirements for states in both managed care and fee-for-service (FFS) delivery systems related to: • Payment adequacy and transparency of Medicaid payment rates to direct care workers; • Critical incident management; • Timeliness of access to services; • Person-centered service planning; • Establishing a grievance system in fee-for-service (FFS) programs; and • Quality measures.