Notice2023-11901
Statement of Organization, Functions, and Delegations of Authority
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
June 5, 2023
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
The Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services has modified its organizational structure.
Full Text
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<title>Federal Register, Volume 88 Issue 107 (Monday, June 5, 2023)</title>
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[Federal Register Volume 88, Number 107 (Monday, June 5, 2023)]
[Notices]
[Pages 36586-36587]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-11901]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Statement of Organization, Functions, and Delegations of
Authority
AGENCY: Centers for Medicare & Medicaid Services.
ACTION: Notice.
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SUMMARY: The Centers for Medicare and Medicaid Services, Center for
Medicaid and CHIP Services has modified its organizational structure.
SUPPLEMENTARY INFORMATION: Part F of the Statement of Organization,
Functions, and Delegations of Authority for the Department of Health
and Human Services, Centers for Medicare &
[[Page 36587]]
Medicaid Services (CMS) (last amended at Federal Register, Vol. 87, No.
205, pp. 64492-64494, dated March 27, 2023) is amended to reflect the
establishment of the Managed Care Group and rename the Disabled and
Elderly Health Programs Group to Medicaid Benefits and Health Programs
Group within the Center for Medicaid and CHIP Services (CMCS).
Part F, Section FC. 10 (Organization) is revised as follows:
Center for Medicaid and CHIP Services, Managed Care Group
Managed Care Group, Division of Managed Care Policy
Managed Care Group, Division of Managed Care Operations
Division of Managed Care Operations, Branch A through D
Center for Medicaid and CHIP Services, Medicaid Benefits and Health
Programs Group
Part F, Section FC. 20 (Functions) for the new organization is as
follows:
Managed Care Group
<bullet> Provides national leadership in the development and
management of Medicaid program policy and operations regarding managed
care programs and provides technical assistance to States and other
stakeholders.
<bullet> Establishes Medicaid program policy around access, and
accountability for all managed care programs regardless of authority
used and including all populations (e.g., Temporary Assistance for
Needy Families, dually eligible, foster care children, individuals who
need long-term services and supports).
<bullet> Provides Medicaid managed care policy and operational
guidance to States as well as internal and external stakeholders to
ensure appropriate application of the policy.
<bullet> Provides subject matter expertise and technical support/
assistance in the review, approval, and oversight of managed care in
Section 1115 demonstrations.
<bullet> Supports delivery systems reform through the development
and implementation of policy around state directed payments including
technical assistance to states, review and approval of 438.6(c)
preprints, and responding to external inquires related to the 438.6(c)
approval process.
<bullet> Establishes and reviews policy and performs operations
related to 1915(b) waivers and 1932(a) SPAs, including the review and
approval of new managed care programs, renewals and amendments to
ensure appropriate application of Medicaid managed care policy in state
Medicaid programs.
<bullet> Leads reviews of state contracts and amendments with
managed care organizations, prepaid inpatient health plans, prepaid
ambulatory health plans, primary care case management entities,
enrollment brokers and external quality review organizations to confirm
that contracts and capitation rates, when applicable, satisfy federal
laws and regulations and are consistent with the Federal managed care
authority(ies) approved by CMS.
<bullet> Reviews at-risk capitation rates for consistency between
the rate certification, the contract provisions, and the Federal
managed care authority (ies) approved by CMS.
<bullet> Reviews and approves state plan amendments and capitation
rates for Programs of All-Inclusive Care of the Elderly.
<bullet> Reviews States' risk mitigation strategies for consistency
between the contract and the rate certification and tracks the status
of risk mitigation reconciliation activities.
<bullet> Conducts readiness assessment reviews and ongoing
monitoring and oversight of Medicaid managed care programs.
<bullet> Collaborates with States in their implementation of
approved managed care programs.
<bullet> Serve as the policy lead and liaison with the Office of
the Actuary in the review and approval of effective and efficient rate
methodologies.
<bullet> The primary point of contact for policy questions on
Mental Health Parity and the application of that policy in the review
of documents provided by States.
Authority: 44 U.S.C. 3101.
Xavier Becerra,
Secretary of Health and Human Services.
[FR Doc. 2023-11901 Filed 6-2-23; 8:45 am]
BILLING CODE 4150-28-P
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</html>Indexed from Federal Register on June 5, 2023.
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