The Kaiser Family Foundation has released a brief examining a recent Centers for Medicare & Medicaid Services (CMS) rule that would set state requirements for ensuring access to care in Medicaid.  Applying to fee-for-services (FFS) Medicaid, the rules would require states to conduct regular reviews of Medicaid-covered services to ensure that they do not prevent access to care.  The brief outlines the review process and how states must rectify access issues they identify.

From the report:

The Medicaid program today provides health and long-term care coverage for about 60 million low-income Americans, including pregnant women, children and parents, people with disabilities, and seniors. Under the Affordable Care Act, beginning in 2014, Medicaid eligibility will expand to reach nearly everyone under age 65 with income below 133% of the federal poverty level ($14,500 for an individual in 2011), bringing an additional 16 million people, mostly uninsured adults, into the program. To help ensure that Medicaid connects enrollees with the care they need, federal Medicaid law establishes a standard for access to care in Medicaid. Specifically, the federal Medicaid statute requires that payments for covered care and services “are consistent with efficiency, economy and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the same extent that such care and services are available to the general population in the geographic area.

Full report: Provider Payment And Access To Medicaid Services: A Summary of CMS' May 6 Proposed Rule (PDF | 579.11 KB)

Kaiser Family Foundation.  (2011).  Provider payment and access to Medicaid services: a summary of CMS' May 6 proposed rule.