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MACPAC Reviews Chapters for June Report to Congress

April 19, 2013—The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) Apr. 11-12 reconvened to discuss chapters in its June report to Congress. The commissioners will meet once more in May to finalize these chapters and issue draft recommendations. The June report will cover a variety of topics, including the two-year primary care payment increase, waivers, maternity care, and program integrity, among other issues.

One of the key chapters in the June report will focus on the primary care payment increase authorized under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). MACPAC staff reviewed previous research regarding the relationship between payment increases and access to care, and also discussed the commission’s survey of states, managed care organizations, and providers on the implementation of the payment increase.  Most of those surveyed expressed concerns with the short term nature of the payment increase, and whether this would actually lead to more primary care physicians serving Medicaid-eligible individuals.  According to MACPAC staff, respondents agreed that an evaluation of the payment increase should be conducted, although there was not an agreement on who should conduct such a review. 

MACPAC staff also updated the commissioners on their work exploring Medicaid waivers. The June report will provide a general overview of all Medicaid waiver authorities, specifically the use and requirements of 1115, 1915(b), and 1915(c) waivers. Waivers are utilized to test demonstration projects, utilize Innovation Center grants, and for home and community based services.  Every state has at least one waiver, and for FY 2012, approximately 41 percent of Medicaid Benefit spending occurred under a waiver.

MACPAC released its fifth report to Congress on March 15. The report focused on Medicaid and CHIP enrollees’ interactions with exchanges; service use, spending patterns, and cost sharing related issues for duals; and ways to improve payment methodologies for integrated care plans. The commission made two recommendations:  

  • That Congress should create a statutory option for states to implement 12-month continuous eligibility for children enrolled in CHIP and adults enrolled in Medicaid, as is now the case for children in Medicaid; and
  • That Congress permanently fund Transitional Medical Assistance (TMA), while allowing states to opt out of TMA if they expand to the new adult group.
    MACPAC’s next report will be released June 15.


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

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


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