Bulletin Board

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. The following is MACPAC’s own summary of its two days of public meetings. MACPAC’s March meeting began with a discussion on the role of automation in the Medicaid prior authorization (PA) process. MACPAC conducted a literature review, a federal policy review, and stakeholder interviews on the role of automation in the PA process. During this session, we reviewed findings and challenges that surfaced in this research, including the extent to which automation is already in [...]

March 16, 2026|Categories: MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care|Tags: Children’s Health Insurance Program policy, CHIP policy, Medicaid and CHIP Payment and Access Commission, Medicaid and PACE, Medicaid and Program of All-Inclusive Care, Medicaid managed care, Medicaid policy, Medicaid prior authorization, Medicaid provider credentialing, Medicaid provider enrollment|

Federal Health Policy Update for March 12

The following is the latest health policy news from the federal government for March 6-12. Some of the language used below is taken directly from government documents. Congress While the House was in recess this week, the Republican caucus held its annual retreat to discuss legislative priorities. Speaker Mike Johnson (R-LA) continues to push for another reconciliation bill, hoping to revisit several proposals to reduce Medicaid spending that were not included in HR another rank-and-file Republicans have expressed doubt that this will be possible. Both chambers of Congress are scheduled [...]

March 12, 2026|Categories: Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare post-acute care, Medicare reimbursement policy|Tags: ASTP/ONC 2026 Interoperability Standards Advisory Reference Edition, CDC and measles, Centers for Disease Control and Prevention and measles, Children’s Health Insurance Program and behavioral health, CMS BALANCE Model, CMS Center for Clinical Standards and Quality strategic roadmap, Congressional Joint Economic Committee, FDA Adverse Event Monitoring System, health care affordability, HHS Office of the Inspector General, hospital price transparency requirements, HR 1, Inpatient Rehabilitation Facility Review Choice Demonstration, Medicaid and behavioral health, Medicaid and GLP-1 drugs, Medicaid and home- and community-based services (HCBS) workforce, Medicaid and PACE, Medicaid and prior authorization, Medicaid and the Program of All-Inclusive Care for the Elderly, Medicaid eligibility re-determinations, Medicaid managed care, Medicaid provider enrollment and credentialing, Medicaid state plan amendments, Medicare Advantage, Medicare and ambulatory surgical centers, Medicare and GLP-1 drugs, Medicare and post-acute care, Medicare fee-for-service payments, Medicare Part D, Medicare Payment Advisory Commission, Medicare Prescription Drug Program, MedPAC, MedPAC annual report to Congress, MLN Connects, One Big Beautiful Bill Act, Organ Procurement Organizations, Risk Identification and Site Criticality Toolkit RISC 2.0|

“Rural Emergency Hospital” Designation Making a Difference for Some Communities

The new (since 2023) classification of some hospitals as “Rural Emergency Hospitals” is proving to be an effective tool for preserving access to care in some rural communities. The program, introduced to help stem the closure of rural hospitals, which was leaving many communities without reasonable access to care, appears to be having the desired effect. Among the benefits reported by the administrators of such hospitals – which must apply for this special federal designation – are preservation of access to emergency and outpatient services, including surgery, laboratory, imaging, and [...]

March 12, 2026|Categories: 340b, hospitals, Medicare|Tags: Medicare, Rural Emergency Hospital, rural health care, Rural hospitals|

CMS Lays Out Medicaid Eligibility Redeterminations

More than eight months after passage of HR 1, the “One Big Beautiful Bill Act,” the Centers for Medicare & Medicaid Services has provided formal guidance to the states on how to redetermine Medicaid eligibility for certain Medicaid beneficiaries – a major part of the bill’s health care changes. Under that law, states must redetermine affected individuals’ continued Medicaid eligibility every six months beginning with renewals scheduled on or after January 1, 2027. CMS is giving states two options for redetermining Medicaid eligibility. They may: move an individual’s previously set 2027 renewal [...]

March 11, 2026|Categories: Medicaid|Tags: HR 1, Medicaid community engagement requirements, Medicaid eligibility, Medicaid eligibility redetermination, Medicaid work requirements, One Big Beautiful Bill Act|

CMS Will Continue Rolling Out Mandatory Models

The Centers for Medicare & Medicaid Services and its Center for Medicare and Medicaid Innovation intend to continue developing and introducing mandatory Medicare models with an emphasis on driving more value-based care. That is the message delivered by CMS administrator Mehmet Oz and CMMI director Abe Sutton during a recent conference. While the track record of CMMI’s models – both voluntary and mandatory – is not great, policymakers believe they remain the best way for government to continue encouraging health care providers to focus more on the delivery of value-based [...]

March 10, 2026|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|Tags: Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, mandatory Medicare models, Medicare accountable care organizations, Medicare ACOs, Medicare models|

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