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  • Washington Highlights

    MACPAC Discusses Supplemental Payments and the Proposed Rule on Nursing Facility Staffing


    Katherine Gaynor, Hospital Policy and Regulatory Analyst
    For Media Inquiries

    The Medicaid and CHIP Payment and Access Commission (MACPAC) met on Sept. 21 and 22 to discuss a variety of policy issues, including hospital supplemental payments, the latest proposed rule on nursing facility staffing and payment transparency, and additional topics related to Medicaid and the Children’s Health Insurance Program (CHIP).  

    During the meeting, MACPAC outlined their work plan to examine hospital supplemental payments, including documenting payment methods, characterizing payment targeting, and identifying overall payment rates. Additional areas for consideration will include: Medicaid utilization, unpaid costs of care for uninsured individuals, hospital finances, other hospital characteristics, and geographic factors and racial/ethnic composition of the surrounding community. The commission also plans to calculate overall hospital payment rates using new supplemental payment data and the Transformed Medicaid Statistical Information System (T-MSIS) to inform analyses of how payment rates vary by state and how they compare to other payers, such as Medicare. Updates on this work will be presented over the next two years as they become available.  

    The commission also discussed potential opportunities for comment on the Centers for Medicare and Medicaid Services’ (CMS) recently proposed rule on nursing facility staffing and payment transparency.t The commission noted their principles for assessing Medicaid nursing facility payment policy and recommendations related to payment transparency included in their March 2023 report to Congress. These recommendations included increased transparency of Medicaid nursing facility payments, costs, and ownership and requiring states to conduct regular assessments of Medicaid nursing facility payments relative to costs, quality outcomes, and health disparities. MACPAC plans to submit comments in response to the proposed rule, which are due Nov. 6.