MACPAC

Federal Health Policy Update for July 9

Don’t Miss: CMS ends fast track process for Medicaid 1115 waiver renewals HHS publishes 2026 regulatory agenda HHS asks hospitals to sign healthy foods pledge The following is the latest health policy news from the federal government for July 3-9. Some of the language used below is taken directly from government documents. Congress Congress will return to session on July 13. Committees with jurisdiction over health care will continue focusing on legislation that could ultimately be incorporated into a reconciliation package, FY 2027 appropriations legislation, or other end-of-year legislation. Centers for Medicare & Medicaid Services (CMS) In the wake of [...]

joe2026-07-09T14:47:22-04:00July 9, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for June 25

Don’t Miss: CMS posts a new presentation on Medicaid eligibility under HR 1 House health subcommittee marks up health care price transparency bills Cassidy proposes 340B bill HRSA announces two maternity-related funding opportunities The following is the latest health policy news from the federal government for June 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee’s Oversight Subcommittee held a hearing to discuss integrity and fraud risk in state Medicaid programs; witnesses included state Medicaid directors from California, Minnesota, New York, and Ohio. For more information, see the press [...]

joe2026-06-25T17:28:47-04:00June 25, 2026|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 18

Don’t Miss: 340B Rebate Model pilot program – next steps Stricter rules on CMS’s reviews of new and existing section 1115 Medicaid demonstration programs Changes in health care institution accrediting practices HHS posts mental and behavioral health grant opportunities The following is the latest health policy news from the federal government for June 12-18. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress will return to session on June 22. The House Energy and Commerce Committee’s Oversight and Investigations Subcommittee will hold a hearing titled “State Medicaid Program Integrity: Examining Fraud Risks [...]

joe2026-06-18T16:07:51-04:00June 18, 2026|340b, Affordable Care Act, Alternative payment models, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

MACPAC Issues Report to Congress

The Medicaid and CHIP Payment and Access Commission has sent its 2026 report to Congress. The report – mandated by Congress – includes recommendations for: overseeing community engagement/work requirements in Medicaid, including MedPAC’s recommendation that the Centers for Medicare & Medicaid Services develop a transparent plan through which it can monitor and evaluate community engagement requirements improving CMS’s oversight of the use of automation in Medicaid prior authorization decisions improving the accountability of states’ Medicaid managed care programs appropriate access to residential treatment services for Medicaid-enrolled youth with special behavioral health needs and disabilities facilitating the transition of children and [...]

joe2026-06-17T09:45:11-04:00June 17, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care|

Federal Health Policy Update for May 28

The following is the latest health policy news from the federal government for May 22-28. Some of the language used below is taken directly from government documents. Congress When Congress returns from the Memorial Day recess next week, lawmakers will have to address the Republican-led reconciliation bill to fund ICE and CBP. After, they plan to start working on a third party-line bill focusing on affordability—including health care—which leadership aims to pass by the end of July. Next week, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies is scheduled to mark up its Fiscal [...]

sysadmin2026-05-28T17:43:32-04:00May 28, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicare, Medicare regulations, Medicare reimbursement policy|

MACPAC Seeks Guardrails for AI Use in Medicaid Prior Authorization

While acknowledging the potential value of the use of AI in facilitating Medicaid prior authorization decisions, the agency that advises Congress on Medicaid and Children’s Health Insurance Program policy will recommend to Congress that the programs erect guardrails to protect those they serve. During a recent meeting of the Medicaid and CHIP Payment and Access Commission, members of that group discussed a staff report on the use of AI in Medicaid prior authorization decisions and endorsed the following principles for the use of AI in this manner: The Secretary of the U.S. Department of Health and Human Services should direct [...]

joe2026-05-13T12:04:25-04:00May 15, 2026|MACPAC, Medicaid, Medicaid managed care|

Federal Health Policy Update for May 14

The following is the latest health policy news from the federal government for May 8-14. Some of the language used below is taken directly from government documents. Congress The Ways and Means Committee has circulated a discussion draft of a bill that would require non-profit hospitals and health systems to report more of their community benefit-related spending activity. Under the draft bill, non-profit hospitals and health systems would be required to report on charity care spending, their process for patients to apply for financial assistance, and spending associated with community benefits. They also would be required to report on subsidized service lines, community health needs assessments, and more. Affected hospitals and health [...]

joe2026-05-14T15:39:30-04:00May 14, 2026|hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and housing for the disabled, Medicaid managed care, Medicare, Medicare reimbursement policy|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. During the course of the deliberations, MACPAC’s staff made the following presentations to the commissioners: Automation in Medicaid Prior Authorization: Recommendations Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly: Recommendations and Updated Implications Appropriate Access to Residential Services for Children and Youth with Behavioral Health Needs: Recommendations Implementing Community Engagement Requirements in Medicaid: Recommendation and Updated Implications Children and Youth with Special Health Care Needs Transitions to Adult Coverage: Recommendations and Updated Implications Click the [...]

joe2026-05-12T14:55:54-04:00May 13, 2026|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and housing, Medicaid and housing for the disabled, Medicaid regulations for the disabled|

Federal Health Policy Update for April 16

The following is the latest health policy news from the federal government for April 11-16. Some of the language used below is taken directly from government documents. CMS – New Proposed Regulations FY 2027 Medicare Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Proposed Rule CMS has published its proposed FY 2027 Medicare hospital inpatient and long-term-care hospital prospective payment system rule. The highlights of the proposed rule are: A 2.4 percent rate increase for both acute-care hospital inpatient and long-term care hospital services. A $564 million reduction in Medicare disproportionate share hospital (Medicare DSH) and [...]

joe2026-04-16T16:21:07-04:00April 16, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. During the course of the deliberations, MACPAC’s staff made the following presentations to the commissioners: Implementing Community Engagement Requirements in Medicaid State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Plans: Draft Chapter Children and Youth with Special Health Care Needs (CYSHCN) Transitions to Adult Coverage: Draft Chapter and Recommendations Automation in the Prior Authorization Process: Draft Recommendations Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly: Policy Options Health and Welfare in Self-Directed [...]

joe2026-04-15T12:51:27-04:00April 16, 2026|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care|