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Access Monitoring Review Plans

Federal regulations at 42 CFR 447.203 and 447.204, implementing section 1902(a)(30)(A) of the Social Security Act (the Act), describe procedures for states and territories to follow in order to document that Medicaid payment rates are sufficient to enlist enough providers so that care and services are available under the state plan at least to the extent that such care and services are available to the general population in the geographic area. Through Access Monitoring Review Plans (AMRPs), states are required to analyze data and supporting information to reach conclusions on sufficient access for covered services provided under fee-for-service. Every three years, states must conduct the analysis for: primary care services (including those provided by a physician, FQHC, clinic, or dental care); physician specialist services; behavioral health services, including mental health and substance use disorder; pre- and post-natal obstetric services, including labor and delivery; and home health services. States are required to include additional services within the AMRPs when proposing to reduce rates or restructure payments in ways that may harm access to care and describe procedures to monitor access over three years once the reductions are approved. The AMRPs, and subsequent additions to the AMRPs, are developed in consultation with a state’s Medical Advisory Committee and subject to a 30 day public comment period prior to submission to the Centers for Medicare & Medicaid Services (CMS). 

States submitted the first round of AMRPs to the CMS on October 1, 2016. The AMRPs are reviewed, but not formally approved, by CMS and are used to determine compliance with the Act as part of the State plan amendment review process. The AMRPs below are the “as submitted” plans received by CMS from states for the first submission period. CMS will update the documents as states amend them for purposes of analyzing and monitoring services subject to rate reductions.

Information contained below is gathered by CMS with assistance from States. If any information is incorrect, please send an email to MedicaidAccesstoCare@cms.hhs.gov

Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.

State Access Monitoring Review Plans Public Notice
Alabama Alabama Access Monitoring Review Plan (PDF, 1.03 MB) Public notice not available
Alaska Alaska Access Monitoring Review Plan (PDF, 553.47 KB) Public notice not available
Arizona Arizona Access Monitoring Review Plan (PDF, 314.94 KB) Public notice not available
Arkansas Arkansas Access Monitoring Review Plan (PDF, 2.75 MB) Public notice not available
California California Access Monitoring Review Plan (PDF, 4.48 MB) Public notice not available
Colorado Colorado Access Monitoring Review Plan (PDF, 8.6 MB) Public notice not available
Connecticut Connecticut Access Monitoring Review Plan (PDF, 1.76 MB) Public notice not available
Delaware Delaware Access Monitoring Review Plan (PDF, 810.06 KB) Public notice not available
District of Columbia District of Columbia Access Monitoring Review Plan (PDF, 3.54 MB) Public notice not available
Florida Florida Access Monitoring Review Plan (PDF, 1.14 MB) Public notice not available
Georgia Georgia Access Monitoring Review Plan (PDF, 1.2 MB) Public notice not available
Guam Guam Access Monitoring Review Plan (PDF, 195.69 KB) Public notice not available
Hawaii Hawaii Access Monitoring Review Plan (PDF, 101 KB) Public notice not available
Idaho Idaho Access Monitoring Review Plan (PDF, 686.12 KB) Public notice not available
Illinois Illinois Access Monitoring Review Plan (PDF, 693.4 KB) Illinois Public Notice
Indiana Indiana Access Monitoring Review Plan (PDF, 1.7 MB) Indiana Public Notice
Iowa Iowa Access Monitoring Review Plan (PDF, 501.48 KB) Iowa Public Notice
Kansas Kansas Access Monitoring Review Plan (PDF, 249.21 KB) Public notice not available
Kentucky Kentucky Access Monitoring Review Plan (PDF, 175.07 KB) Public notice not available
Louisiana Louisiana Access Monitoring Review Plan (PDF, 747.02 KB) Public notice not available
Maine Maine Access Monitoring Review Plan (PDF, 607.77 KB) Public notice not available
Maryland Maryland Access Monitoring Review Plan (PDF, 740.15 KB) Public notice not available
Massachusetts Massachusetts Access Monitoring Review Plan (PDF, 410.62 KB) Public notice not available
Michigan Michigan Access Monitoring Review Plan (PDF, 690.4 KB) Michigan Public Notice
Minnesota Minnesota Access Monitoring Review Plan (PDF, 2.07 MB) Public notice not available
Mississippi Mississippi Access Monitoring Review Plan (PDF, 1.13 MB) Public notice not available
Missouri Missouri Access Monitoring Review Plan (PDF, 1.58 MB) Public notice not available
Montana Montana Access Monitoring Review Plan (PDF, 1.33 MB) Montana Public Notice
Nebraska Nebraska Access Monitoring Review Plan (PDF, 2.18 MB) Nebraska Public Notice
Nevada Nevada Access Monitoring Review Plan (PDF, 585.69 KB) Public notice not available
New Hampshire New Hampshire Access Monitoring Review Plan (PDF, 1.74 MB) Public notice not available
New Jersey New Jersey Access Monitoring Review Plan (PDF, 467.97 KB) Public notice not available
New Mexico New Mexico Access Monitoring Review Plan (PDF, 1.53 MB) Public notice not available
New York New York Access Monitoring Review Plan (PDF, 933.28 KB) Public notice not available
North Carolina North Carolina Access Monitoring Review Plan (PDF, 1.49 MB) Public notice not available
North Dakota North Dakota Access Monitoring Review Plan (PDF, 6 MB) North Dakota Public Notice
Ohio Ohio Access Monitoring Review Plan (PDF, 19.63 MB) Public notice not available
Oklahoma Oklahoma Access Monitoring Review Plan (PDF, 6.23 MB) Public notice not available
Oregon Oregon Access Monitoring Review Plan (PDF, 768.05 KB) Public notice not available
Pennsylvania Pennsylvania Access Monitoring Review Plan (PDF, 688.58 KB) Public notice not available
Rhode Island Rhode Island Access Monitoring Review Plan (PDF, 436.05 KB) Public notice not available
South Carolina South Carolina Access Monitoring Review Plan (PDF, 2.89 MB) Public notice not available
South Dakota South Dakota Access Monitoring Review Plan (PDF, 938.11 KB) Public notice not available
Texas Texas Access Monitoring Review Plan (PDF, 471.97 KB) Public notice not available
Utah Utah Access Monitoring Review Plan (PDF, 1.58 MB) Public notice not available
Virgin Islands Virgin Island Access Monitoring Review Plan (PDF, 611.55 KB) Public notice not available
Virginia Virginia Access Monitoring Review Plan (PDF, 5.06 MB) Public notice not available
Washington Washington Access Monitoring Review Plan (PDF, 4.18 MB) Public notice not available
West Virginia West Virginia Access Monitoring Review Plan (PDF, 1.26 MB) West Virginia Public Notice
Wisconsin Wisconsin Access Monitoring Review Plan (PDF, 1.48 MB) Public notice not available
Wyoming Wyoming Access Monitoring Review Plan (PDF, 1.07 MB) Public notice not available

Urban Report

On November 2, 2015, CMS issued the Request for Information (RFI): Data Metrics and Alternative Processes for Access to Care in the Medicaid Program to inform the potential development of standards with regard to Medicaid beneficiaries’ access to covered services under the Medicaid program. CMS solicited information on four specific topic areas: 1) developing a core set of measures of access that all states would monitor and publicly report on in the state’s access monitoring review plan; 2) measuring access to long term care and home and community based services; 3) setting national access to care thresholds; and 4) establishing a process that would allow beneficiaries experiencing access issues to raise and seek resolution of their concerns. To help analyze the responses to the RFI, CMS engaged the Urban Institute to develop a report entitled “Proposed Medicaid Access Measurement and Monitoring Plan (PDF, 1.01 MB) .” Through their efforts, the Urban Institute identified readily available data elements currently in use by CMS and states through other programs, initiatives, and resources that may be used to measure access to care, such as the Adult and Child Core Set, Consumer Assessment of Healthcare Providers and Systems (CAHPS), and the Healthcare Effectiveness Data and Information Set (HEDIS). CMS is making the final report available as a technical assistance tool for states. The report is for informational purposes and the framework described within is not mandated.