The Medicaid and CHIP Payment Access Commission (MACPAC) published an issue brief on the updated regulations for oversight of Medicaid managed care and state allowances for the direction of managed care organizations (MCOs).
Earlier this year, the Centers for Medicare and Medicaid Services (CMS) issued a rule for the directed payment...
The Issue brief defines prior authorization and how this process used by Medicaid fee-for-service programs and managed care organizations (MCOs) requires approval before providing specific items, services, or medications.
Prior authorization (PA) aims to prevent unnecessary utilization, limit improper, fraudulent, and wasteful...
The Medicaid and CHIP Payment and Access Commission (MACPAC) report focuses on improving the Medicaid beneficiary experience through Medical Care Advisory Committees (MCACs), increasing the transparency and improving the monitoring of the denials and appeals process in Medicaid managed care, and a review of hospital payment policy for...National News
Last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) held its annual meeting where the draft of the annual March Report to Congress on Medicaid and the Children's Health Insurance Program (CHIP) was presented.
In the meeting, the commission discussed and voted on seven recommendations to change the mechanism for...Arizona News
Rates of syphilis in infants continues to rise according to a new study from the Centers for Disease Control and Prevention (CDC).
The CDC said in a media statement that it would recommend "concerted action" to decrease the cases of newborn syphilis, which is a consequence of the rapid epidemic of sexually transmitted infections...CMS Rules
The FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (LTCH PPS) rule was finalized by the Centers for Medicare and Medicaid Services (CMS) on August 1 and contains a shocking projected cut to disproportionate share hospitals (DSH).
For all hospitals, the rule provides...
On June 15, 2023, the Medicaid and CHIP Payment and Access Commission (MACPAC) issued its June Report to Congress which includes recommendations for DSH payments, delivering on the promise of dual integration and access to Medicaid coverage for released prisoners. MACPAC is an independent, non-partisan commission composed of experts in...
Now CEO and President for JSN Strategies, Jami Snyder served as director of Arizona's Medicaid agency, the Arizona Health Care Cost Containment System (AHCCCS), from 2019 through December 2022. MACPAC reviews Medicaid and CHIP access and payment policies and advises Congress on issues affecting Medicaid and CHIP.
Before joining...White Papers, E books, Reports and more
The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) released its 2023 data book on dually eligible beneficiaries this week.
Dual-eligible beneficiaries receive Medicare as the primary payer, which covers medical services including physician, inpatient and outpatient care....Arizona News
The 2022 edition of the MACStats: Medicaid and CHIP Data Book presents the most current data available on Medicaid and the State Children’s Health Insurance Program (CHIP).
According to the report, Arizona's budget for its Medicaid program in 2020 was $40.8 million representing 31% of total federal and state spending; Arizona...National News
Last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) published findings in a review of Medicaid payment rates for nursing facility services across states and found major inconsistencies in reimbursement.
Nursing facilities are payed through base payments, which are usually per diem, and supplemental payments, paid...
The BA.2 variant, also known as the "stealth Omicron," is now the dominant coronavirus version in the U.S. and more than 60 other countries. This week, Philadelphia became the first major city in the U.S. to announce that it would return to mandating masks in public spaces due to the spread of BA.2. Meanwhile, Arizona, the Centers for...
The Medicaid and CHIP Payment and Access Commission (MACPAC) biannual report includes three topics of interest to Congress including (1) a lengthy, and eventually inconclusive, comparative analysis of residential care settings under HCBS and the Money Follows the Person (MFP) demonstration program, (2) a discussion on policy...National News
While states continue to try to implement their own solutions to the nationwide nursing home staffing shortage, MACPAC recently released a brief which echoes the Biden administration’s call for minimum staffing standards and various pay incentives to help retain staff.
The brief, issued by MACPAC, outlines three main solutions...National News
Medicaid plays an important role in providing health insurance to low-income adults, children, people with disabilities, and others who would otherwise face significant financial barriers to healthcare. New briefs from Medicaid and CHIP Payment and Access Commission (MACPAC) analyze the current differences in healthcare access between...National News
The Medicaid and CHIP Payment and Access Commission (MACPAC) sent its March 2021 Report to Congress on Tuesday. The Report generally includes recommendations for legislative adjustments to Medicaid and the Children's Health Insurance Program (CHIP), and this one included suggestions for Medicaid's response to current economic...Arizona News
Change and reform are in the air for AHCCCS and the Medicaid program at large. The Biden administration is eyeing moves to undo major Trump administration reforms to the program and AHCCCS has announced some important changes for Arizona beneficiaries.
The Medicaid and CHIP Payment Access Commission (MACPAC) voted late last week to...National News
Hospitals and providers are unsure when the loans will be collected, and HHS is only now putting forth guidance on reporting for CARES Act funding recipients. This disruption and subsequent uncertainty has led to struggling hospitals not even applying for critical assistance from HHS.
At the beginning of the COVID-19 pandemic, the...National News
In a letter this week, the nonpartisan commission continued its criticism of the state's work requirement to Health and Human Services Secretary Alex Azar; Arkansas has no plans to pause the program, the first in the nation.
So far about 8,500 beneficiaries have been kicked off Arkansas' Medicaid program since its work requirement...
