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Medicaid

Coverage and Delivery Reform

Medicaid is a joint federal and state safety net program that assists over 60 million low-income individuals in receiving access to clinician offices, acute and long term care services. Teaching hospitals treat a disproportionate share of Medicaid patients, with approximately 28% of all Medicaid discharges coming from COTH hospitals.

Medicaid also plays a critical role in funding graduate medical education. State and local governments, through their Medicaid programs, appropriate approximately $5 billion for medical school training annually. Most states choose to allocate a portion of their Medicaid budget to fund direct graduate medical education (DGME), indirect medical education (IME), and other special services related to teaching hospitals. Due to state budget shortfalls and the prevalence of Medicaid managed care organizations, there are serious concerns that fewer Medicaid funds will be available to train future physicians.


News and Updates


MedPAC Discusses Modernizing the Medicare-Dependent Hospital Program and Integrating Dual-Eligible Special Needs Plans

November 9, 2018

The Medicare Payment Advisory Commission (MedPAC) met Nov. 12 to discuss several issues, including potential policies for modernizing the Medicare-Dependent Hospital (MDH) program and integrating Medicare and Medicaid for dual-eligible special needs plans (D-SNPs).


CMS Releases Medicaid and CHIP Managed Care Proposed Rule

November 9, 2018

The Centers for Medicare and Medicaid Services (CMS) Nov. 8 released a proposed rule aimed at streamlining the Medicaid and Children’s Health Insurance Plan (CHIP) managed care regulatory requirements through reduced state administrative burden and enhanced flexibility for states to manage their Medicaid and CHIP programs. According to the administration, the proposed rule strives to decrease regulatory burden, promote transparency, and allow for flexibility and innovation in care delivery.


MACPAC Discusses DSH Allotments, the Public Charge Rule’s Impact on Medicaid, and Work Requirements in Arkansas

October 26, 2018

The Medicaid and CHIP Payment and Access Commission (MACPAC) met Oct. 25-26 to discuss several issues, including analyses of Medicaid disproportionate share hospital (DSH) allotments, policy options for implementing statutorily mandated DSH allotment reductions, the impact of work and community engagement requirements on Medicaid beneficiaries in Arkansas, and the effect of the Department of Homeland Security’s (DHS) proposed “public charge” rule on recipients of assistance under Medicaid and the Children’s Health Insurance Program (CHIP).


GAO Releases Report on Health Care Access in Medicaid Expansion, Non-Expansion States

October 18, 2018

The U.S. Government Accountability Office (GAO) Sept. 13 released a report evaluating access to health care for low-income adults in states with and without expanded Medicaid eligibility under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). According to the GAO, as of December 2017, 31 states and the District of Columbia had exercised the ACA option to expand their Medicaid programs to non-disabled, non-elderly adults, with the federal government paying a higher percentage of the cost than otherwise available to state Medicaid programs.


CMS Proposes to Require Prescription Drug Price Disclosure in TV Ads

October 18, 2018

The Centers for Medicare and Medicaid Services (CMS) Oct. 15 released a proposed rule that would require drug manufacturers to disclose the list price for prescription drugs and biologics in direct-to-consumer television advertisements. CMS defines the list price as the wholesale acquisition cost. The drug’s price would be displayed at the end of the advertisement in a manner that is easily readable.  


On Government Affairs



Testimony and Correspondence





External Resources