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However, differing Medicare and Medicaid standards and review processes can pose a challenge to fulfilling this requirement: CMS specifies the required number of MA providers and facility types for every county in every state and time and distance requirements for how long and how far beneficiaries should be made to travel to access providers and facilities.[6] These requirements are based on the population size and demographics of the general MA population, as opposed to Medicaid provider network adequacy standards, which vary by state and are outlined in state Medicaid agency health plan contracts that must conform to federal Medicaid standards (42 CFR 438.206(a)

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CTK solution (0.25% trypsin + 1 mg/mL collagenase IV + 1 mM CaCl 2 + 20% KSR in DPBS ()) was prepared with trypsin ((2.5%), no phenol red, Thermo Fisher Scientific Inc.), collagenase (type IV, powder, Thermo Fisher Scientific Inc.), calcium chloride dihydrate (Fujifilm Wako Pure Chemical Corporation), Knock Out TM Serum Replacement (KSR, Thermo Fisher Scientific Inc.)