MACPAC

MACPAC Issues Annual Report to Congress

The Medicaid and CHIP Payment and Access Commission has issued its annual report to Congress. This year’s MACPAC report primarily addresses three issues: How state Medicaid agencies can improve beneficiary engagement with state medical care advisory committees and what the federal government can do to facilitate that engagement. The current process for monitoring and overseeing denials of care and appeals of those denials by Medicaid managed care plans and how states and the federal government can improve those processes and make them more transparent. MACPAC’s annual review of Medicaid disproportionate share (Medicaid DSH) allotments to states. MACPAC is a non-partisan [...]

joe2024-03-20T14:28:46-04:00March 21, 2024|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Federal Health Policy Update for March 14

The following is the latest health policy news from the federal government for March 8-14. Some of the language used below is taken directly from government documents. The White House The Biden administration this week released its proposed FY 2025 federal budget. Health care highlights include: Making permanent the expanded health care premium tax credits introduced to make health insurance marketplace plans more affordable for middle-class Americans. Extension of coverage similar to Medicaid to residents of the 10 states that have not taken advantage of the Affordable Care Act opportunity to expand their Medicaid programs. Permission for states to extend [...]

joe2024-03-14T20:46:56-04:00March 14, 2024|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for February 8

The following is the latest health policy news from the federal government for February 2 - 8. Some of the language used below is taken directly from government documents. Congress Members of the Senate’s 340B bipartisan working group have released a discussion draft of legislation that would update the 340B prescription drug discount program. Last year the group sought stakeholder input on policy solutions that might provide stability and transparency to the 340B program to ensure that the program can continue to achieve its original intent of supporting entities serving eligible patients. Find a news release describing the discussion draft [...]

joe2024-02-08T20:43:44-05:00February 8, 2024|340b, Centers for Medicare & Medicaid Services, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care, Telehealth|

Federal Health Policy Update for January 25

The following is the latest health policy news from the federal government for January 12 - 25. Some of the language used below is taken directly from government documents. Department of Health and Human Services – Funding Models HHS has announced a new model to test approaches for addressing the behavioral and physical health and health-related social needs of people with Medicaid and Medicare. The goal of the Innovation in Behavioral Health Model (IBH) is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorders by connecting them with the physical, behavioral, [...]

joe2024-01-25T22:30:26-05:00January 25, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|

Federal Health Policy Update for January 11

The following is the latest health policy news from the federal government for January 5 - 11. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS will establish 200 new Medicare-funded residency slots in FY 2025. Learn more about the additional slots here and find information about how to apply for those slots here. The deadline for applications is March 31. CMS released guidance for Medicare Part D plans that describes coverage and processing claims for COVID-19 therapeutics. Medicare Part D plans must cover commercially available oral antivirals for COVID-19 [...]

joe2024-01-11T21:27:47-05:00January 11, 2024|hospitals, MACPAC, Medicaid, Medicare, Medicare reimbursement policy, Telehealth|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the meeting. MACPAC’s December 2023 meeting opened with a session that highlighted findings related to sexual orientation and gender identity (SOGI) data collection as part of the Commission’s focus on the collection of primary language and limited English proficiency, SOGI, and disability data for the purposes of assessing and addressing health disparities. During this discussion, we reviewed the purpose of SOGI data and federal and state priorities for collecting these data, which includes an overview of [...]

joe2023-12-19T15:36:42-05:00December 19, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days recently in Washington, D.C. The following is MACPAC’s own summary of the meeting. To kick off MACPAC’s November meeting, the Commission continued its work on denials and appeals in Medicaid managed care with a review of findings from beneficiary focus groups. Medicaid managed care organizations (MCOs) manage and provide care to beneficiaries enrolled in their plans. Beneficiaries have the right to appeal MCO coverage decisions. Federal rules require that states have monitoring systems in place to provide oversight of MCOs and their appeals systems. This session described key challenges [...]

iqtsupport2023-11-14T06:00:32-05:00November 14, 2023|Centers for Medicare & Medicaid Services, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care|

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9. Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023. The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor by 2.15 percent rather than the 3.4 percent that CMS [...]

iqtsupport2023-11-09T15:41:22-05:00November 9, 2023|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for October 12

The following is the latest health policy news from the federal government for October 6-12. Some of the language used below is taken directly from government documents. No Surprises Act CMS has reopened the federal independent dispute resolution (IDR) portal for the initiation ofnew single disputes, including single disputes involving bundled payment arrangements, but parties still cannot initiate new disputes involving air ambulance services and batched disputes for air ambulance and non-air ambulance items and services. IDR portal functionalities related to previously initiated batched disputes also are unavailable. Learn more about this action from this CMS announcement, which includes an [...]

iqtsupport2023-10-12T14:42:15-04:00October 12, 2023|COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|

Federal Health Policy Update for September 28

The following is the latest health policy news from the federal government for September 22-28. Some of the language used below is taken directly from government documents. The White House President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act, which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network. Congress Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend. While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has [...]

iqtsupport2023-09-28T16:38:25-04:00September 28, 2023|Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Telehealth|