Statement attributed to:
Jesse M. Ehrenfeld, M.D., MPH
President, American Medical Association

“The American Medical Association (AMA) commends the Centers for Medicare & Medicaid Services (CMS) for historic rules that will strengthen access to care and improve health outcomes for Medicaid patients across fee-for-service and managed care delivery systems. The AMA has long sought changes to the Medicaid payment policies that drive inadequate and inequitable access to care for too many Medicaid patients, and we are grateful for the Administration’s commitment to monitoring and mitigating longstanding payment-related access barriers.

“Together, these two rules will help ensure low-income patients in Medicaid have access to affordable, high-quality health care services and advance health equity. We thank the Administration for pursuing solutions to longstanding barriers to care.

“The ‘Managed Care Rule’ will help ensure timely access to care by establishing maximum appointment wait-time standards and requiring annual payment analyses and consistent quality reporting for key services, as well as improving monitoring and enforcement mechanisms to ensure managed care plans are meeting the needs of Medicaid patients.

“The ‘Access Rule’ promotes transparency and accountability by requiring states to publish fee-for-service payment rates, requiring states that want to substantively restructure plans or reduce rates to demonstrate that sufficient access will be retained, and strengthening channels for Medicaid patients to provide input into the program.

“While we need to ensure that these common-sense protections are put in place without passing the compliance burdens onto safety net practices, overall, we look forward to working with CMS to implement these reforms to advance patient access and quality of care by empowering Medicaid patients, their physicians, policymakers, and advocates with access to information previously unavailable to the public. At the end of the day, transparency is good medicine.”