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MACPAC Discusses Substance Abuse Disorder Treatment, Hospital Payments

January 26, 2018

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PRESS CONTACTS
Jennifer Faerberg, Director, Clinical Transformation Unit
Kate Ogden, Physician Payment & Quality Specialist

The Medicaid and CHIP Payment and Access Commission (MACPAC) met Jan. 25-26 to discuss a variety of issues, including substance abuse disorder treatment and Medicaid hospital payment.

MACPAC staff provided a brief background on the 42 CFR Part 2 Substance Abuse Disorder Confidentiality Regulations and reviewed the themes from a Nov. 2017 MACPAC sponsored roundtable on the regulations. Five themes emerged where there was broad agreement amongst participants including:

  • Disclosure of diagnosis or treatment can expose patients to harm
  • Deterrent to seeking care
  • Limitations on sharing information may cause harm
  • Widespread confusion over Part 2’s application
  • Existing technological barriers to information sharing
  • Negative effects on Medicaid delivery systems

Commissioners discussed the need for clear sub-regulatory guidance to remove confusion and their concern in existing barriers to provide whole person care. The commission will continue to discuss this topic at a future meeting with forthcoming recommendations on integration and care coordination. 

MACPAC staff also presented a proposed analytic work plan on Medicaid hospital payment policy for the upcoming year. Proposed focus areas include how Medicaid hospital rates are determined, whether Medicaid hospital rates are adequate, and how Medicaid hospital payments are used in delivery system transformation.  

MACPAC commissioners questioned how traditional Medicaid payments compare to Medicaid managed care payments to hospitals and what share of these hospital payments are tied to incentives for higher value care. MACPAC staff will present additional information based on this work plan at the commission’s spring meeting.

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