MACPAC Releases March 2024 Report to Congress on Medicaid and CHIP   

The Medicaid and CHIP Payment and Access Commission (MACPAC) released their March 2024 Report to Congress on Medicaid and CHIP. This report contains three chapters that reviews hospital payment policies for safety-net hospitals and provides recommendations to improve Medicaid beneficiaries’ experience through Medical Care Advisory Committees (MCACs) and increase transparency and improve monitoring of the denials and appeals in Medicaid managed care.  

The first chapter focused on beneficiary engagement and provided three recommendations to address beneficiary recruitment and implementation challenges as well as urge state Medicaid agencies to strengthen efforts to recruit beneficiary members from historically marginalized communities. The second chapter looks at monitoring and oversight of denials and appeals in Medicaid managed care and includes seven recommendations aimed at improving these processes. The third chapter contained a review of Medicaid disproportionate share hospital (DSH) allotments to states, which remained unchanged from previous years. The analysis found little relationship between state DSH allotments and the number of uninsured individuals; the amounts and sources of hospitals’ uncompensated care costs; and the number of hospitals with high levels of uncompensated care that also provide essential community services for low-income, uninsured, and vulnerable populations. Finally, as next steps to this chapter, MACPAC noted that the commission is engaging in a long-term work plan to also examine other types of payments to hospitals using newly available data on non-DSH supplemental payments and directed payments.