ADVI Analysis: MACPAC November 2023 Meeting

MACPAC held a meeting November 2-3, 2023 (link). The following relevant topics were discussed:

• Improving the Managed Care Appeals Process
• Unwinding the Continuous Coverage Requirement in Medicaid: State and Managed Care Plan Strategies

ADVI Angle

Key takeaways from the November meeting include:

• Improving the Managed Care Appeals Process
  • Commissioners largely supported the following policy options, although some expressed concerns with the first:
    1. CMS should require states to establish an independent, external medical review process for beneficiaries.
    2. CMS should issue rulemaking and guidance on continuation of benefits.
    3. CMS should issue guidance to improve beneficiary access to and support throughout the appeals process.
    4. CMS should require that managed care organizations (MCOs) provide beneficiaries with a choice to receive notices in an electronic format.
  • At the January 2024 MACPAC meeting, staff will present a draft chapter on this topic and Commissioners will vote on the policy recommendations.
• Unwinding the Continuous Coverage Requirement in Medicaid: State and Managed Care Plan Strategies
  • Several panelists presented on state and managed care organization (MCO) strategies used during the Medicaid redeterminations process.
  • Commissioners supported the continued use of temporary flexibilities after unwinding, state strategies to increase outreach to members, and increased data collection.
  • Commissioners supported more integration between assistance programs (e.g., SNAP, Medicaid).

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