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December 2018 Public Meeting

The December 2018 MACPAC meeting covered a broad array of Medicaid issues. Rebekah Gee, secretary of the Louisiana Department of Health, and Paul Jeffrey, director of pharmacy at MassHealth, kicked off Thursday’s session with a panel discussion of their states’ innovative strategies to counter the rising cost of prescription drugs. Later in the morning, the Commission looked at how states with Medicaid managed care programs oversee network adequacy and access to care.

On Thursday afternoon, the Commission discussed options for recommendations on how to structure DSH allotment reductions and proposed recommendations to improve compliance with upper payment limits for hospitals, which are expected to be part of the March 2019 report to Congress. The Commission is expected to vote on these recommendations at its January 2019 meeting. The Commission also looked at a proposed rule to revise managed care regulations. At the final session of the day, the Commission reviewed another proposed rule to improve the integration of Medicare and Medicaid benefits and unify the grievance and appeals processes for dually eligible beneficiaries enrolled in dual eligible special needs plans.

Friday began with a panel to inform the Commission’s consideration of Medicaid in Puerto Rico. Angela Avila, executive director of Puerto Rico’s Administración de Seguros de Salud, Orlando Gonzalez, president of the managed care organization MMM Healthcare, and Gloria Amador, chief executive officer of the federally qualified health center Salud Integral en la Montaña, Inc., discussed challenges and opportunities for Medicaid in the commonwealth.  The panel was followed by a presentation highlighting key facts and trends from the just-released December 2018 edition of the MACStats data book. The Commission deferred review of the results of a study assessing return on investment in 10 different Medicaid program integrity approaches until its January meeting.


  1. Panel Discussion: State Innovations in Drug Pricing
  2. Network Adequacy in Managed Care
  3. Disproportionate Share Hospital Allotment Reductions: Proposed Recommendations
  4. Upper Payment Limits for Hospitals: Proposed Recommendations to Improve Compliance
  5. Review of Proposed Revisions to Medicaid and CHIP Managed Care Rules
  6. Review of Proposed Rule Affecting Integrated Care for Dually Eligible Beneficiaries
  7. Panel Discussion: Medicaid in Puerto Rico
  8. Highlights from the 2018 Edition of MACStats