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MACPAC Finalizes Chapters, Makes Recommendations for March Report to Congress

February 15, 2013—The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) Feb. 12-13 reconvened to finalize chapters and issue recommendations in their March report to Congress. Chapter topics include Medicaid payments to DSH hospitals, eligibility issues for Medicaid and CHIP enrollees under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) and future Medicaid expenditures, among other issues.

The commission voted unanimously on two recommendations to Congress in the March report. The first recommendation urges Congress to provide statutory authority for 12-month continuous eligibility for children enrolled in CHIP and adults enrolled in Medicaid. The second recommendation asks that Congress permanently fund current transitional medical assistance (TMA) for Medicaid enrollees. Under this recommendation, states would have the option to opt-out of TMA if they expand coverage to new Medicaid-eligible adults.

MACPAC’s first day of meetings began with a presentation on Washington state’s integration of Medicaid and public health systems to explore new methods to deliver services, be more cost effective, boost accountability, and improve outcomes. Panelists included Washington State Secretary of Health Mary Selecky and Doug Porter, former director, Washington Health Care Authority. The commission then received results from a survey from six states and the District of Columbia on the progress and implementation of the Medicaid primary care physician payment increase.

The meeting continued with a presentation from Julie Boughn, Deputy Director, Center for Medicaid and CHIP Services at CMS, on initiatives to improve data for program operations and evaluation. Staff provided the commissioners with an overview of the partial-benefit Medicaid/Medicare dually eligible population, including the characteristics of this population and the role that Medicaid plays in providing their coverage. After discussion on the proposed Medicaid rule (see related story) on eligibility, benefits, and cost sharing, the commission decided to move forward with submitting comments that address the 12-month continuous eligibility in CHIP and electronic submission of the Medicaid and CHIP state plans.

The commission concluded the day by reviewing and finalizing content in its March report to Congress. The March report will again include a chapter on Medicaid and CHIP Statistics (MACStats), which focuses on state-specific Medicaid and CHIP enrollment, spending, eligibility levels, covered benefits, cost sharing, and federal medical assistance percentages. It will also include contextual information on state budgets and national health expenditures, along with reference points such as the dollar amounts of common federal poverty levels used to determine eligibility.


Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806

Scott Wetzel, M.P.P.
Lead, Quality Reporting
Telephone: 202-828-0495


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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806