Are You Meeting CMS and State Access-to-Care Requirements? In the 2025 Final Rule, CMS released its expectations and reporting requirements to ensure timely access to care. Effective January 1, 2025, CMS requires issuers that offer Qualified Health Plans (QHPs), including stand-alone dental plans, to take specific actions.
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By Jocelyn Bayliss The 2025 Final Rule from CMS outlined expectations and reporting requirements related to timely access to care. Effective PY 2025, CMS requires that all states with Medicaid and the Children’s Health Insurance Program (CHIP) develop, conduct, and enforce independent secret shopper surveys to evaluate
Read More →The Centers for Medicare & Medicaid Services (CMS) requires that all health plans have written standards for access to care timeliness and member services. Your health plan is required to: Most states have a standard set requirement for primary and specialty care access and availability. Is your
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