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September 2018 Public Meeting

The Medicaid and CHIP Payment and Access Commission’s September 2018 public meeting opened with Rhonda Anderson from the Oregon Health and Science University and Elena Nicollela from the New England States Consortium Systems Organization presenting state perspectives on multistate collaboration. In the afternoon, the Commission held two of three sessions at this meeting on hospital payment. At the first session, staff briefed Commissioners on recent interviews with officials and stakeholders in five states focusing on why states choose particular payment methods and how managed care affects hospital payment. It was followed by a session on policy options for disproportionate share hospital (DSH) payments, slated for reductions in fiscal year 2020.

Later, the Commission received an update on the status of Medicaid work and community engagement requirements—approved in Arkansas, Indiana, and New Hampshire, but currently in effect only in Arkansas. Thursday wrapped up with a session on policy options for Medicaid payment of new and high-cost drugs, continuing a discussion begun in 2017.

On Friday, the Commission delved into managed care oversight, important at this juncture when more than 80 percent of Medicaid beneficiaries are enrolled in some form of managed care. The Commission then turned to its third session on hospital payment, this time examining how various states determine hospitals’ upper payment limits and options for strengthening federal oversight. At the final session Friday morning, the Commission began to lay out the issues for an upcoming mandated report on therapeutic foster care.


  1. Multistate Collaboration: Panel on State Perspectives
  2. Themes from Interviews on the Development of Hospital Payment Policies
  3. DSH Payments: Policy Changes and Policy Options
  4. Operational Considerations for Work and Community Engagement Requirements
  5. Medicaid Coverage of New and High-Cost Drugs
  6. Managed Care Oversight
  7. Oversight of UPL Payments: Additional Analyses and Policy Options
  8. Mandated Report: Therapeutic Foster Care