Sending Office: Honorable Rosa L. DeLauro
Sent By:
Caitlin.Peruccio@mail.house.gov

Current Cosigners: Reps. Wild, Norton, Grijalva, Barbara Lee, and Raskin

Dear Colleague

Please join me in opposing CMS’s proposed repeal of the Medicaid Access Rule, which ensures CMS and each state’s Medicaid agency know health care is truly accessible to those who receive their coverage through Medicaid.

The Medicaid Access Rule requires state Medicaid agencies to analyze access to primary care, physician specialists, behavioral health care, pre- and post-natal obstetric care (including labor and delivery), and home health care for Medicaid beneficiaries.
Repeal of the Rule would lead to far too many health care providers to refuse seeing or even treating Medicaid beneficiaries, who are our country’s most vulnerable. If the current regulatory scheme were eliminated, we would be left with a Medicaid program
that would give states the license to cut fee-for-service provider rates without any review and oversight. As a result, Medicaid beneficiaries would face longer wait times or be forced to travel a significant distance from their homes to see providers that
continue to participate in Medicaid.

If you have any questions regarding this letter and to join this letter, please contact Caitlin Peruccio (Caitlin.Peruccio@mail.house.gov or 6-8958). The deadline to join is COB, Thursday, September
12th. This deadline will be final, as comments are due to CMS at 5pm on Friday, September 13th. 

Sincerely,

Rosa L. DeLauro

Member of Congress

 

 

Text of the Letter:

 

Seema Verma

Administrator

Centers for Medicare & Medicaid Services

U. S. Department of Health and Human Services

200 Independence Avenue, SW

Washington, DC 20201

 

Dear Administrator Verma,

We write to oppose the proposed repeal of the Medicaid Access Rule, which would drastically weaken the Centers for Medicare and Medicaid Services’ oversight of and enforcement authority over the covered services in state Medicaid programs. The repeal of
the Medicaid Access Rule would lead far too many health care providers to refuse seeing or even treating Medicaid beneficiaries, who are our country’s most vulnerable. As a result, Medicaid beneficiaries would face longer wait times and be forced to travel
a significant distance from their homes to see providers that continue to participate in Medicaid.

The goal of the Medicaid Access Rule is to guarantee that CMS and each state’s Medicaid agency know health care is truly accessible to those who receive their coverage through Medicaid, and to hold states accountable if that is not the case. If the current
regulatory scheme were eliminated, we would be left with a Medicaid program that would give states the license to cut fee-for-service provider rates without any review and oversight. For those states that utilize managed care payment rates based on the fee-for-service
rates, the cut to the fee-for-service provider rates would likely lead to a reduction in capitation rates. Such cuts are likely to result in fewer providers participating in state Medicaid programs, making it harder for beneficiaries to access covered services.

The Medicaid Access Rule requires state Medicaid agencies to analyze access to primary care, physician specialists, behavioral health care, pre- and postnatal obstetric care (including labor and delivery), and home health care for Medicaid beneficiaries.
Given the maternal mortality, mental health, and aging crises we are currently experiencing in the United States of America, it is imperative that if states want to reduce payments, they must prove that beneficiaries and their families will not be harmed by
these rate reductions. To repeal the Medicaid Access Rule without any accountability and mechanism in place will only harm our country’s most vulnerable.

With state budgetary constraints, it is critical the federal government plays its role to ensure states do not cut provider rates to save money without establishing the effect on a beneficiary’s access to health care. We are alarmed that CMS would consider
such a repeal without undertaking and presenting any alternative that would establish adequate oversight to ensure beneficiaries do not lose access to health care providers. The repeal of the Medicaid Access Rule could be a matter of life and death for the
millions of individuals that rely Medicaid for their health coverage. For all these reasons, we oppose the proposed repeal of the Medicaid Access Rule to ensure all Medicaid beneficiaries, including babies, children, individuals with disabilities, and seniors
have access to health care providers.

Related Legislative Issues

Selected legislative information: HealthCare

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