Medicaid MLTSS

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. Supporting the discussion were the following briefing papers: Background on Medicaid Race and Ethnicity Data Collection and Reporting State Strategies and Stakeholder Engagement for Unwinding the Public Health Emergency Continuous Coverage Requirement Improving Rate Setting and Risk Mitigation in Medicaid Managed Care Principles for Assessing Medicaid Nursing Facility Payments Relative to Costs Countercyclical Disproportionate Share Hospital Policies Medicaid Coverage of Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease Review of Proposed Rule on Core Set Reporting and Congressional Request for [...]

admin2022-09-23T06:00:12+00:00September 23, 2022|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid long-term services and supports, Medicaid managed care|

States, Feds Not Adequately Monitoring Medicaid MLTSS

With more states delegating their programs of Medicaid managed long-term services and supports to managed care entities, state Medicaid programs and the federal government are not adequately overseeing the work of those managed care plans. As a result, they sometimes fail to notice quality and access problems for beneficiaries, according to the U.S. Government Accountability Office. When states delegate to managed care plans decisions about the amount and types of services that adults and children with physical, cognitive, and mental disabilities will receive, federal guidelines require states to monitor those decisions for appropriateness. In too many cases, the GAO has [...]

admin2020-12-21T06:00:34+00:00December 21, 2020|Medicaid long-term services and supports|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that advises Congress, the administration, and the states on Medicaid and CHIP issues, met publicly in Washington, D.C. last week. The following is MACPAC’s own summary of its two days of meetings. The April 2018 meeting began with session on social determinants of health. Panelists Jocelyn Guyer of Manatt Health Solutions, Arlene Ash of the University of Massachusetts Medical School, and Kevin Moore of UnitedHealthcare Community & State discussed state approaches to financing social interventions through Medicaid. In its second morning session, the Commission reviewed a draft [...]

admin2018-04-23T06:00:05+00:00April 23, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. to discuss a variety of Medicaid and Children’s Health Insurance Program issues. MACPAC, the non-partisan legislative branch agency that performs policy and data analysis and makes recommendations to Congress, the administration, and the states, addressed a number of issues during the meeting. Among them it discussed Medicaid managed long-term services and supports (MLTSS) and voted to recommend that states be given the opportunity to seek permission to make Medicaid beneficiary enrollment in managed care plans mandatory through revisions of their state plan amendment rather than by [...]

admin2018-01-30T06:00:58+00:00January 30, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid managed care|

GAO: Improvement Needed in MLTSS Oversight

The Centers for Medicare & Medicaid Services needs to improve the job it does overseeing state Medicaid programs of managed long-term services and supports. According to a new report by the U.S. Government Accountability Office, 22 states use MLTSS programs to help qualified seniors continue living independently in the community and to save money on nursing home costs. CMS’s oversight of these efforts, and of the use of federal funds, is inconsistent and often falls short when monitoring key considerations such as provider network adequacy, critical incidents, and appeals and grievances. To address these concerns, the GAO recommends that CMS [...]

admin2017-09-21T06:00:37+00:00September 21, 2017|Medicaid, Medicaid long-term services and supports|

GAO Looks at MLTSS Rates, Oversight

Federal oversight of the manner in which states pay for Medicaid-covered managed long-term services and supports and of the data states use to set the rates for those services and supports is lacking, according to a new study by the U.S. Government Accountability Office. In a review of such practices in six states, GAO found that states are not adequately linking payments and penalties to performance toward achieving MLTSS goals for providing more care in the community and are using outdated data to set rates that federal regulations require to be “appropriate and adequate.” Learn more about what the GAO [...]

admin2017-02-14T06:00:38+00:00February 14, 2017|Medicaid|