The Medicaid and CHIP Payment and Access Commission (MACPAC) met Oct. 26-27 to discuss a variety of issues, including an update on the Children’s Health Insurance Program (CHIP), opioid use disorders, and Medicaid disproportionate share hospital (DSH) payments.
MACPAC staff led an update on the status of federal CHIP funding, which expired at the end of September. Staff provided an overview of current congressional action to extend CHIP funding and reiterated MACPAC’s previous recommendation for a five-year funding extension with the current 23 percentage point increase to the CHIP matching rate through fiscal year (FY) 2022. Commissioners discussed next steps and suggested that MACPAC publish updated projections on when states will exhaust their funds.
Commission staff then provided an overview of their continued work on opioid use disorders and highlighted three projects currently underway or being planned. These include: an analysis on gaps in care continuum, assembling a compendium of recovery support services, and convening an expert roundtable to better understand how privacy regulations for substance use disorder treatment records affect clinical and administrative practices.
Staff provided a summary of a roundtable discussion on Medicaid DSH that the commission convened in September. Roundtable participants, which included representatives from states and hospitals, acknowledged that while DSH policies have evolved along with other state Medicaid payments, they value the ability to target DSH payments to areas of greatest need. Participants noted they are “planning for the worst case scenario” given the uncertainty related to DSH allotment reductions and other policy changes affecting their ability to plan for the future. Additionally, the participants called for a phase-in of any policy change in order minimize disruption and to allow states to test new approaches rather than adding new requirements.