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October 2015 Public Meeting

MACPAC opened its October 2015 Commission meeting with a discussion of the draft of the upcoming report on Medicaid disproportionate share hospital (DSH) payments. The DSH report will include a recommendation—approved unanimously at the October meeting—calling on the U.S. Department of Health and Human Services Secretary to collect and report hospital-specific data on all types of Medicaid payments for all hospitals that receive them. The recommendation also calls for the Secretary to collect and report data on the sources of non-federal share necessary to determine net Medicaid payment at the provider level. The report is part of MACPAC’s statutory mandate and will be issued February 1, 2016.

The Commission continued its examination of the affordability of children’s coverage, with estimates of out-of-pocket spending in separate CHIP compared to coverage offered on the exchanges and a briefing on children’s coverage in employer-sponsored plans.

Later, the Commission explored how states assess functional eligibility for Medicaid-covered long-term services and supports with a review of findings from a comprehensive, nationwide inventory of functional assessment tools.

Commissioners returned to Medicaid spending in the final segments of the day with a session on policy levers affecting federal and state spending on Medicaid, part of their comprehensive review of approaches to reduce the rate of growth in spending. That session was followed by a presentation on recent trends in fee-for-service and managed care drug spending and rebates, and factors contributing to drug spending’s recent growth.


  1. Medicaid Disproportionate Share Hospital Payments: Review of the Draft Report
  2. Out-of-Pocket Spending for Children in Separate CHIP versus Exchange Coverage
  3. Trends in Employer-Sponsored Insurance Related to Children’s Coverage
  4. Functional Assessment Tools for Medicaid Long-Term Services and Supports
  5. Policy Levers That Affect Spending
  6. Trends in Medicaid Spending for Prescription Drugs