Medicaid and CHIP Payment and Access Commission

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 [...]

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 [...]

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 [...]

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 [...]

Federal Health Policy Update for July 28

The following is the latest health policy news from the federal government for July 21 -28.  Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has published a final rule to update Medicare payment policies and rates under its inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2024.  The final rule includes a 3.4 percent rate increase and changes in the outlier threshold, the case-mix-group relative weights and average length of stay values, and the wage index.  In addition, this rule rebases and revises the IRF market [...]

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16.  Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.”  The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

MACPAC Looks at Medicaid State Directed Payments

In 2016, the Centers for Medicare & Medicaid Services authorized states to direct Medicaid managed care organizations to pay providers according to specific rates or methods.  Typically, states use these arrangements, often referred to as state directed payments, to establish minimum payments for certain types of providers or to require participation in value-based payment arrangements.  A few states, though, use state directed payments to require Medicaid managed care organizations to make large, additional payments to providers similar to supplemental payments their Medicaid fee-for-service programs. In a new issue brief, the Medicaid and CHIP Payment and Access Commission describes the history [...]

Federal Health Policy Update for June 29

The following is the latest health policy news from the federal government for June 23-29.  Some of the language used below is taken directly from government documents. The White House President Biden has issued an executive order on strengthening access to affordable contraception and family planning services for women with private health insurance and through Medicaid, Medicare, and federally supported health programs and to foster research on access.  Learn more from this White House fact sheet and the administration’s executive order.   Department of Health and Human Services HHS’s Office of the Inspector General (OIG) has posted its final rule [...]

MACPAC Proposes New Approach to Helping Safety-Net Hospitals

To improve “…the relationship between total state and federal DSH [Medicaid disproportionate share] funding and the number of non-elderly low-income individuals in a state,” the Medicaid and CHIP Payment and Access Commission has urged Congress to direct the Department of Health and Human Services to change how it calculates Medicaid DSH allotments to the states. This year MACPAC devotes a significant portion of its annual report to Congress to payment policy for safety-net hospitals, and in summarizing its proposal it writes that: In order to reduce the wide variation in state disproportionate share hospital (DSH) allotments based on historical spending, [...]

Federal Health Policy Update for June 22

The following is the latest health policy news from the federal government for June 9-22.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals.  The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families.  The new flexibilities include permitting managed care plans to assist people currently [...]

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