The writing is on the wall. There are well-documented issues of a lack of uniformity and accountability surrounding state Medicaid programs. Understanding CMS’s history of recognizing problems and acting to find solutions, it stands to reason the agency will, in the future, establish compliance programs for state Medicaid plans that mirror those of Medicare.
When CMS establishes greater control and oversight of Medicaid at the state level, government-sponsored health plans will have a new set of issues to work through in order to comply with the new regulatory guidance. The good news is these new regulations will most certainly mirror those already in effect for Medicare. Therefore, mirroring best practices in Medicare compliance today will better position health plans in the future.