Biden-Harris Admin Announces Request for Info re. Access to Care/Coverage for Medicaid/CHIP enrollees

This is potentially a pretty big deal:

As part of the Biden-Harris Administration’s work to advance health equity and reduce health disparities, the Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access, such as enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality. This Request for Information (RFI) is one of many actions CMS is taking to develop a more comprehensive access strategy in its Medicaid and CHIP programs.

“We are committed to providing equitable access to quality health care and removing any barriers to quality health care,” said Health and Human Services Secretary Xavier Becerra. “We want to hear directly from stakeholders so we can strengthen our programs for the more than 80 million Americans with Medicaid or CHIP health insurance. Together, by advancing health equity, we can ensure quality health care is within reach for everyone who needs it.” 

 “Medicaid and CHIP provide essential health coverage for over 80 million individuals and families,” said CMS Administrator Chiquita Brooks-LaSure. “Ensuring every eligible person can access the coverage and care to which they are entitled is a foundational principle of health equity and our work at CMS. We invite interested stakeholders and individuals with lived experience to join us in this mission, starting by responding to the request for information.” 

“With this RFI, we are taking a first step towards a broader perspective of what ‘access’ to Medicaid means,” said CMS Director of the Center for Medicaid and CHIP Services Daniel Tsai. “Ensuring access to Medicaid includes addressing a range of barriers current and potential Medicaid beneficiaries may experience, from enrolling in Medicaid to maintaining coverage, to accessing care across both fee-for-service and managed care delivery systems. Access must also cross physical health care, behavioral health, and home and community based services. We look forward to capturing a wide range of perspectives from different stakeholders with this RFI.” 

Feedback obtained from the RFI announced today will aid in CMS’ understanding of enrollees’ barriers to enrolling in and maintaining coverage and accessing needed health care services and support through Medicaid and CHIP. This information will help inform future polices, monitoring, and regulatory actions, helping ensure beneficiaries have equitable access to high-quality and appropriate care across all Medicaid and CHIP payment and delivery systems, including fee-for-service, managed care, and alternative payment models. The RFI submissions will also inform CMS’ work to ensure timely access to critical services, such as behavioral health care and home and community-based services.  

Evidence shows that while Medicaid and CHIP generally provide comprehensive coverage for health care services, some enrollees still experience challenges accessing providers and medical services despite statutory access protections in Medicaid. CMS’ access RFI aims to gather information to help understand many of these concerns with feedback from experts, beneficiaries, and community members with lived experience of the agency’s programs.

The RFI seeks feedback from a diverse set of stakeholders on a broad set of topics from ensuring adequate payment rates to encouraging provider availability and quality, to culturally and linguistically competent care and reducing gaps in health care coverage. Interested parties may access the RFI questions and provide comment on Medicaid.gov.  The RFI is open for a 60 day public comment period beginning February 17, 2022.

Read the RFI