[20150603]IF10234_CMS提出的医疗补助管理医疗规则.pdf

www.crs.gov | 7-5700 June 3, 2015CMS Proposed Rule on Medicaid Managed CareWhat Is the Proposed Rule? On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule laying out the agencys plan to update the federal regulations pertaining to Medicaid managed care, under which states contract with private health insurers to provide health care to enrollees. In general, federal agencies develop regulations to implement the laws passed by the Congress. CMS has that responsibility for Medicaid and the State Childrens Health Insurance Program (CHIP). This includes how states deliver services to Medicaid enrollees through risk-based managed care, the primary focus of the proposed rule. The proposed rule also addresses managed care in CHIP and third party liability (TPL) in Medicaid, but those topics are not the focus of this brief report. What Is the Current Status of the Proposed Rule? CMS is taking public comments on the proposed rule through July 27, 2015. Once the comment period closes, CMS will review the comments and make any changes before preparing a final rule for review by the Office of Management and Budget (OMB). OMB review, which typically las