ADVI Analysis: MACPAC Meeting September 2023

The Medicaid and CHIP Payment and Access Commission (MACPAC) held its latest meeting on September 21-22, 2023 (link). The following relevant topics were discussed. 

• Monitoring and oversight of managed care denials and appeals
• Medicaid unwinding: Challenges to date and what’s to come
• Ex parte renewals

ADVI Angle

The following are key takeaways from the September Meeting

• Monitoring and oversight of managed care denials and appeals
  • Commissioners were broadly supportive of 4 policy options that aim to improve data collection and monitoring, the use of clinical audits, and public reporting related to Medicaid managed care denials and appeals.
  • MACPAC staff will move forward with developing the policy options into formal recommendations (timeline not specified).
• Medicaid unwinding: Challenges to date and what’s to come 
  • Commissioners broadly supported continued data collection on disenrollments, even after the unwinding period concludes.
  • Commissioners also discussed the need for increased communication between the states and CMS and including stakeholders in policy development discussions.
• Ex parte renewals
  • The Commission discussed findings from an Ex Parte Roundtable held June 27 and 29, 2023. Attendees to the roundtable included CMS representatives, representatives from six Medicaid agencies, policy experts, beneficiary advocates, and IT system vendors. MACPAC staff intend to publish an issue brief with the findings from the roundtable in coming weeks (timeline not specified).

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