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This final rule advances CMS’ efforts to streamline the Medicaid and CHIP managed care regulatory framework and reflects a broader strategy to relieve regulatory burdens; support State flexibility and local leadership; and promote transparency, flexibility, and innovation in the delivery of care.

Statement of Need:

This final rule advances CMS’ efforts to streamline the Medicaid and CHIP managed care regulatory framework and reflects a broader strategy to relieve regulatory burdens; support state flexibility and local leadership; and promote transparency, flexibility, and innovation in the delivery of care.

Summary of the Legal Basis:

Section 1102 of the Social Security Act (42 U.S.C. 1302).

Alternatives:

The HHS letter to the nation’s governors on March 14, 2017, committed to a review of the managed care regulations in order to prioritize beneficiary outcomes and state priorities.  We reviewed the managed care regulations in accordance with this commitment.

Anticipated Costs and Benefits:

This rule is intended to streamline the federal requirements for Medicaid and CHIP managed care and is expected to reduce administrative burden and result in some estimated cost savings.  The rule is not economically significant.

Risks:

The revisions of the regulations are intended to ensure that the regulatory framework is efficient and feasible for states to implement in a cost effective manner and addresses the risks identified in previous rulemaking.  This would ensure that States operating State Medicaid and CHIP managed care programs can implement program and fiscal integrities without undue administrative burdens