Federal Access to Medicaid Services Rule

In April 2024, the Centers for Medicare and Medicaid Services (CMS) issued the Ensuring Access to Medicaid Services Final Rule (Access Rule, CMS-2442-F) regarding member access and quality of care. The intent of the Access Rule is to improve health outcomes for Medicaid beneficiaries across fee-for-service (FFS) and managed care delivery systems, including home and community-based services (HCBS) provided through those delivery systems. 

The Access Rule includes multiple implementation requirements with phased deadlines beginning in July 2025 and continuing through July 2030. These timelines may be updated based on future federal guidance or policy changes. For the complete federal requirements, please refer to the Access Rule published in the Federal Register - Ensuring Access to Medicaid Services.

Goals of the Access Rule 

Improve access to care, quality, and health outcomes
Address health equity issues
Increase transparency and accountability
Standardize data and monitoring
Promote beneficiary engagement

Send related questions to ohhs.medicaidprogramcao@ohhs.ri.gov

Timeline

2025	July 9, 2025 Medicaid Advisory Committee/Beneficiary Advisory Committee
2026	July 9, 2026 Grievance System for FFS (under enforcement discretion by CMS until December 31, 2027) Payment Rate Transparency Medicaid Fee for Service Fee Schedule Bundled Payment Methodology HCBS Payment Rate Disclosure Comparative Rate Analysis Interested Parties Advisory Group (under enforcement discretion until January 1, 2029) September 1, 2026 HCBS Quality Measure Set
2027	July 9, 2027 Incident Management System and Critical Incident Reporting and Minimum Performance
2029	July 9, 2029 Electronic Incident Management System
2030	July 9, 2030 80% HCBS Direct Care Worker Compensation Requirement