Public notice is required for certain changes to Medicaid and must be published before the effective date of the change being made.
Public Notice is required for the following:
- Any change that eliminates or restricts eligibility or benefits for beneficiaries.
- Any change to establish or substantially modify existing premiums or cost sharing, or change the consequences for non-payment.
- Applications for a demonstration project, or an extension of an existing demonstration project.
- Any significant change in methods and standards for setting payment rates for services, except when:
- The change is being made to conform to Medicare methods or levels of reimbursement;
- The change is required by court order; or
- The change is based on changes in wholesalers’ or manufacturers’ prices of drugs or materials, if the agency’s reimbursement system is based on material cost plus a professional fee.
- Any change to the Alternative Benefit Plan.
Public Notices must be published before the effective date of change being made. Waiver renewals and amendments and some SPAs (i.e. ABP amendments) will require longer public comment periods, as stated in CFR (30 days for waivers/demonstrations) and/or specified by CMS (SPAs).
The Policy Unit strives to issue public notice 30 days prior to the effective date of implementation for all changes requiring public notice.
Last updated: 10/15/2020