Blogging Live from AHLA: Calder Lynch on the Medicaid Program

During the opening session of AHLA yesterday, we had the opportunity to hear remarks for Calder Lynch, current Counselor to CMS Administrator Seema Verma and potential replacement pick for outgoing CMCS Director. Lynch reiterated the three pronged approach the current administration is taking to Medicaid (as previously outlined by administrator Verma):

  1. Accountability
  2. Flexibility
  3. Program Integrity

According to Lynch, these “three pillars guide our efforts as we look to the future of the program.” And what does that future look like? Well, we received a little preview. In particular, Lynch mentioned several soon-to-be-released rules/guidance documents designed o address these three pillars:

  • A Notice of Proposed Rulemaking making changes/revisions to the 2016 Medicaid Managed Care Rule to make it less burdensome on providers;
  • A Notice of Proposed Rulemaking on revising the 2015 Access to Care regulations (and what do you know – it got posted today – we have a summary in the works);
  • New Guidance on Home and Community Based Services (we think this will address the previous Administration’s controversial guidance on the heightened scrutiny standard applies to setting that isolate);
  • New Guidance on Improving the State Plan Amendment Process

Mr. Lynch also mentioned a renewed effort to evaluate the impact of 1115 waivers – citing the agency’s recent decision to terminate DSHP funding. Based on this, I believe we should be looking for similar efforts to target areas where the agency thinks Federal funding has strayed from its initial purpose. More soon!

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