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    MACPAC Discusses Medicaid Financing and Physician-administered Drugs

    Shahid Zaman, Director, Hospital Payment Policy
    Katherine Gaynor, Hospital Policy and Regulatory Analyst
    For Media Inquiries

    The Medicaid and CHIP Payment and Access Commission (MACPAC) met on March 7 and 8 to discuss proposed recommendations for improving the transparency of Medicaid financing as well as Physician administered drugs.  

    The commission discussed a recommendation to improve transparency and enable greater analysis of Medicaid payments. This recommendation would urge Congress to require states to submit and make publicly available an annual, comprehensive report on their Medicaid financing methods and the amounts of the non-federal share of Medicaid spending derived from specific providers. The commission will continue to evaluate during their April meeting.  

    MACPAC also shared findings from an expert roundtable on physician-administered drugs (PADs) that was convened to identify issues related to PADs and strategies to manage spending and utilization of high-cost PADs. State officials participating in the roundtable raised concerns about the impact of the rising cost of PADs on their budgets and bundled payments not adequately covering drug costs, particularly for cell and gene therapies. MACPAC outlined potential strategies for addressing these concerns including reducing the mark-up that is paid on PADs, tiering payment to providers based on drug characteristics, and tying drug payment amounts to 340B providers to the amount of charity care and community benefit provided. The commission will next draft an issue brief highlighting the challenges identified in the roundtable and potential payment and utilization management strategies.