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December 2020 Public Meeting

The December 2020 MACPAC meeting opened with a panel discussion on the role of Medicaid in improving health equity. It included Jamila Michener, associate professor of government at Cornell University; Dena Williams Hasan, director of policy and program support for the District of Columbia Department of Health Services; and Adrienne McFadden, vice president and chief population health officer of Humana’s national Medicaid program. *

After a break, the Commission continued its discussion of extending Medicaid coverage for pregnant women beyond 60 days postpartum. The Commission will vote on recommendations to make such coverage mandatory at an enhanced federal matching rate at its January 2021 meeting. This was followed by comment on an interim final rule affecting Medicaid provisions of the Families First Coronavirus Response Act (P.L 116-172). The Commission plans to comment on this rule by the January 4 deadline.

Later, staff highlighted some of the key facts and trends from the December 2020 MACStats: Medicaid and CHIP Data Book, noting that this is the first edition of MACStats to use data from the Transformed Medicaid Statistical Information System (T-MSIS). This was followed by a staff presentation on options for recommendations that the Commission could make in its March report for an automatic countercyclical financing adjustment in Medicaid. The day concluded with a presentation on integrating clinical care through greater use of electronic health records by behavioral health providers.

On Friday, the day began with a session on access to behavioral health services for children and youth in Medicaid. It was followed by a related panel discussion on mental health services with John O’Brien, a senior consultant with the Technical Assistance Collaborative; Dan Tsai, assistant secretary for MassHealth and Medicaid director for Massachusetts; and Kristine Herman, chief in the Bureau of Behavioral Health at the Illinois Department of Healthcare and Family Services. *

After a break, the Commission focused on the implications of the 2020 congressional and presidential elections for Medicaid policy. The Commission is considering sending letters to the incoming Administration and the 117th Congress on a number of policy issues that affect Medicaid, including prior Commission recommendations that have not been implemented. Next, staff provided an update on MACPAC’s recent work on estate recovery in Medicaid, including a discussion of themes from stakeholder interviews. The Commission considered the implications for three draft recommendations that it plans to vote on at its January meeting.

The Commission then heard a staff presentation on quality rating systems in Medicaid managed care. The meeting concluded with a staff presentation on the factors affecting state decisions on how to pay nursing facilities, including the challenges to value-based payment for these providers.

*  No presentations were prepared for the panel discussions.


  1. Extending Postpartum Coverage: Additional Analysis on Mandatory vs. Optional Approaches
  2. Review of Interim Final Rule Affecting Medicaid Provisions of the Families First Coronavirus Response Act
  3. Highlights from the 2020 Edition of MACStats
  4. A Countercyclical Medicaid Financing Adjustment: Moving towards Recommendations
  5. Integrating Clinical Care through Greater Use of Electronic Health Records by Behavioral Health Providers
  6. Access to Behavioral Health Services for Children and Adolescents
  7. The 2020 Elections: Implications for Medicaid Policy
  8. Medicaid Estate Recovery: Updates on Analyses and Draft Recommendations
  9. Quality Rating Systems in Medicaid Managed Care
  10. Themes from Interviews on the Development of Nursing Facility Payment Methods