CMS published a Final Rule in theFederal Register today, November 2, 2015, that implements a process for states to determine whether Medicaid payments satisfy what is known as the Medicaid “access requirement.”  Specifically, Social Security Act Section 1902(a)(30(A) requires that states have methods and procedures to ensure that payments are “sufficient to enlist enough providers so that care and services are available under the plan at least to the same extent that such care and services are available to the general population in the geographic area.”  Notably, the Final Rule does not require states to raise payment rates.  Rather, it requires states to consider access when setting and adjusting payment methodologies and to address, through any number of steps, any problems with access that are identified.