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  • Washington Highlights

    MACPAC Releases June 2020 Report to Congress


    Mary Mullaney, Director, Hospital Payment Policies

    The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2020 Report to Congress on Medicaid and CHIP on June 15. 

    This year’s report addresses improving integration of care for dually eligible beneficiaries who have both Medicaid and Medicare coverage; increasing enrollment in the Medicare Savings Programs (MSPs) that use Medicaid funds to cover certain Medicare costs for low-income beneficiaries; ensuring that Medicaid remains the payer of last resort when beneficiaries have other sources of coverage; and discussing Medicaid’s role in maternal health.

    MACPAC is a nonpartisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).

    The June report discusses ways to improve the integration of acute care, long-term services and supports, behavioral health, and social needs of dually eligible beneficiaries.

    The commission recommends aligning the MSP eligibility rules with the Medicare Part D Low Income Subsidy (LIS) program. Medicaid pays for Medicare premiums and copays for beneficiaries enrolled in an MSP, but low enrollment in the MSPs has been an ongoing concern since lack of financial assistance can limit access to care. The commission expects bringing state-set MSP eligibility rules in line with the single set of federal rules in the LIS program will not only increase MSP enrollment but also make administration easier for states.

    To protect the safety-net programs’ statutory role of the payer of last resort, MACPAC looks specifically at third-party liability coordination with TRICARE, the health insurer for U.S. military personnel, military retirees, and their dependents — almost 900,000 of whom also have Medicaid coverage.

    Lastly, the report looks at Medicaid’s role in maternal health and the increasing rates of mortality and morbidity among pregnant women and new mothers. It also looks at substance use disorder in pregnant women covered by Medicaid and their newborns.