CMS Ensuring Access to Medicaid Services Final Rule

The Centers for Medicare & Medicaid Services (CMS) published the Ensuring Access to Medicaid Services Final Rule (CMS-2442-F) on April 22, 2024. This rule aims to enhance access to care, improve service quality, and address health equity challenges for Medi-Cal beneficiaries across fee for service (FFS) and managed care delivery systems, including home and community-based services (HCBS) provided through those delivery systems.

FFS Medi-Cal Payment Rate Transparency and HCBS Payment Rate Disclosure

IHSS provider wage rates are established through collective bargaining negotiations conducted by individual counties.

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Fee Restrictions

  • Health care providers and clinics shall not charge a fee to a patient for filling out any forms related to an IHSS applicant’s eligibility determination or providing information responsive to forms that support a claim or appeal regarding eligibility for a public benefit program (Health and Safety Code Section 123114).
  • Prohibited form fees should be reported to Adult Programs Division, Policy and Quality Assurance Branch, Policy, and Operations Bureau at (916) 651-5350.