So the state-directed payment proposed rule helped us understand in plain terms what does this rule actually do and how would it affect access to mental health and addiction care specifically.

Okay, so this is where we have to distinguish from what the law says and what the proposed rule is doing, because again, this is part of that pattern where CMS, the agency, is going much further than what the law said.

So the law said that these state-directed payments, which are basically when a state tells a Medicaid managed care organization how much it has to spend on a service, the HR1 capped certain state-directed payments.

It said that hospital inpatient, hospital outpatient, academic medical center, and skilled nursing, so just four, four services, would have to be capped, and they couldn't go beyond the Medicare rates, essentially.

So then when CMS proposed its rule, which came out recently, comments are due on the 21st of July, CMS decided it was going to not limit it to those four services, but to extend the state directed payment limits to all services.

And they weren't only going to do it for state directed payments.

They were also going to do it.

So what can we do with all these threats to Medicaid? What protections are actually in place? What rights do we have if folks are denied care or lose coverage? How can someone appeal a bad decision, get help if they're getting kicked off Medicaid because of paperwork issues or community engagement requirements? So help folks understand what rights do folks have? What avenues do we have? if we get kicked out.