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Access to Care

Medicaid and the Children’s Health Insurance Program (CHIP) provide critical health coverage for millions of people. Through these programs, the Centers for Medicare and Medicaid Services (CMS) supports access to care in many ways. Most importantly, people gain access to health care services that may not be affordable without Medicaid or CHIP. Additionally, some programs and benefits include special protections—such as provider network and payment methods—that help ensure services are accessible.

Preventive care and other services help people stay healthy and avoid more costly care. CMS offers materials, toolkits, and other resources for states to help Medicaid and CHIP beneficiaries learn about these services and how to access them. CMS also supports many efforts to measure access, share the results, and promote progress. 

Proposed Rule

CMS published a Notice of Proposed Rulemaking (NPRM) titled, “Ensuring Access to Medicaid Services (CMS 2442-P)” on April 27, 2023. The proposed rule takes a comprehensive approach to improving access to care and quality and health outcomes, and seeks to better address health equity issues in the Medicaid program across fee for service and managed care delivery systems, including in home and community based services (HCBS) programs. If finalized, these proposed changes would increase transparency and accountability and standardize data and monitoring, and would create opportunities for states to promote active beneficiary engagement in their Medicaid programs, with the goal of improving access to care.

Comments on this proposed rule must be submitted by July 3, 2023.  Additional Information:


Request for Information (2022)

The Request for Information (RFI): Access to Coverage and Care in Medicaid & CHIP was open for a 60 day public comment period from February 17, 2022 through April 18, 2022. The RFI is now closed. CMS requested feedback from all interested stakeholders on topics related to health care access in Medicaid and CHIP including: enrollment in coverage; maintaining coverage; and access to services and supports.


CMS-issued regulations and guidance to assist with implementation, monitoring and reporting.