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September 2017 Public Meeting

The September 2017 meeting opened with a panel featuring Gail Wilensky, who led the Health Care Financing Administration during President George H.W. Bush’s administration, and Andy Slavitt, who headed up the Centers for Medicare & Medicaid Services (CMS) under President Barack Obama,* discussing their shared perspective on steps to substantive, long-term Medicaid reform laid out in a Journal of the American Medical Association op-ed they co-authored in July.

In the subsequent morning session, the Commission focused on lessons learned for value-based payment from a study of Delivery System Reform Incentive Payment (DSRIP) waivers currently approved in 13 states. The morning wrapped up with an examination of Medicaid enrollment and renewal processes, and whether there are opportunities to improve efficiency and streamlining.

On Thursday afternoon, the Commission began framing issues surrounding state flexibility and program accountability, a topic the Commission plans to address in its March 2018 report to Congress. As part of this discussion, the Commission reviewed key elements of managed care oversight, and examined the performance measures and evaluation methods required for Section 1115 research and demonstration waivers. The final session of the day looked at waiver requests from seven states seeking to implement a combination of work requirements, time limits, or drug testing as conditions of eligibility.

The meeting reconvened on Friday with a session on policy options for controlling Medicaid spending on prescription drugs. Later, Tim Engelhardt,* director of the CMS Federal Coordinated Health Care Office, briefed the Commission on CMS initiatives related to beneficiaries who are dually eligible for Medicare and Medicaid. The September meeting concluded with a session on Medicaid policy issues in telemedicine.

*MACPAC did not prepare a slide presentation for this session.


  1. Implications of the Latest Round of Delivery System Reform Incentive Payment Waivers
  2. Medicaid Enrollment and Renewal Processes
  3. State Flexibility and Program Accountability: Framing Work for the 2017–2018 Report Cycle
  4. Managed Care Oversight
  5. Monitoring and Evaluating Section 1115 Research and Demonstration Waivers
  6. State Requests Affecting Medicaid Eligibility under Section 1115 Research and Demonstration Waivers
  7. Policy Options for Controlling Medicaid Spending on Prescription Drugs
  8. Medicaid Coverage of Telemedicine