MedPAC, MACPAC Hold April Meetings

MedPAC

The Medicare Payment Advisory Commission (MedPAC) held its final public meeting of the 2024-2025 meeting cycle from April 10-11. The commission heard presentations about, discussed, and voted on Medicare-related recommendations relevant to their upcoming report to Congress. Topics included:

• Payment incentives
• Ground ambulance data collection
• Preferred networks and pharmacy access in Part D
• Medicare Advantage enrollment and hospitals' finances
• Institutional Special Needs Plans

In the discussion on Medicare Advantage enrollment and hospitals' finances, MedPAC commissioners shared their findings that Medicare Advantage enrollment does not seem to correlate to hospital financial wellness. However, the analysis also recognized that some Medicare Advantage plans are electing to exclude disproportionate share hospitals (DSH) with particularly high DSH adjustments from their networks.

MedPAC will publish more details on these and other topics in its upcoming June Report to Congress. MedPAC typically meets seven times per annual cycle and publishes reports in March and June.

MACPAC

The Medicaid and CHIP Payment and Access Commission (MACPAC) hosted its penultimate meeting of the term April 9-10. Commissioners met to hear public presentations and lead public discussion about key Medicaid issues, including:

• Community engagement requirements
• Managed care plan accountability
• Automation in Medicaid prior authorization
• Pharmacy benefit managers in Medicaid
• Medicaid program integrity

Commissioners voted on several draft recommendations for the June report to Congress, including recommendations on community engagement requirements. Commissioners will recommend the Centers for Medicare & Medicaid Services (CMS) develop a plan for monitoring and evaluating community engagement requirements in Medicaid. The plan should cover the requirements' effect on eligibility and enrollment, health status, employment, state and federal administrative spending, and attainment of other identified policy goals.

MACPAC meets six times a year and submits reports to Congress in March and June. MACPAC's final meeting of the term is May 7.

Members of the America's Essential Hospitals Federal Action Network (FAN) can access a full summary of both discussions on our FAN Resource Center. To access these summaries and other policy resources, join the FAN today.

Contact Director of Policy Rob Nelb, MPH, at [email protected] or 202.585.0127 with questions.