Medicaid operates in the five U.S. territories: American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands. Unlike state Medicaid programs, financing for territorial Medicaid programs is capped, meaning territories can only access federal funds up to an annual ceiling. Additionally, although the federal matching rate ... [Read More]
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 ... [Read More]
In this session, the Commission heard from a panel of officials from U.S. territories regarding issues facing their programs, including a major reduction in federal Medicaid funds (or fiscal cliff) that will occur in October 2021 without congressional intervention. Panelists include:
Helen Sablan, Medicaid Administrator, Commonwealth of the Northern Mariana Islands State Medicaid Agency
Jorge Galva Rodriguez, ... [Read More]
The Commission wrapped up its work on the June 2019 Report to Congress on Medicaid and CHIP at the April meeting, with sessions reviewing four of the report’s five draft chapters on Thursday morning, and votes on potential recommendations later in the afternoon.
First on Thursday’s agenda was a draft June chapter on Medicaid prescription drug ... [Read More]
In the June 2019 Report to Congress on Medicaid and CHIP, MACPAC responds to congressional requests for analysis and makes recommendations on Medicaid payment and coverage policies for outpatient prescription drugs, hospital payment, program integrity, therapeutic foster care, and challenges facing Puerto Rico’s Medicaid program.
Chapter 1 addresses improving prescription drug policy under Medicaid, ... [Read More]
MACPAC looked ahead to its June 2019 report to Congress on the initial day of the March 2019 Commission meeting. In the morning, sessions focused on potential recommendations to create a grace period for states to determine coverage policies for outpatient prescription drugs and removing or raising the rebate cap; a uniform definition of therapeutic ... [Read More]
Medicaid operates in the five U.S. territories: American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI). Although territories are generally considered states for the purposes of Medicaid unless otherwise specified, their programs differ substantially from those in the states and from one another. ... [Read More]
The March 2021 MACPAC meeting opened with staff presentations on policy options for behavioral health services for adults, youth, and children who are covered by Medicaid and the State Children’s Health Insurance Program (CHIP). Information from these presentations will be included in MACPAC’s June report to Congress.
At prior Commission meetings, MACPAC discussed the limited availability ... [Read More]
Current Exceptions to Standard Federal Match Rates
Statutory exception
Federal match rate
Social Security Act and other citations
Notes
Territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands)
55 percent unless temporary enhanced FMAP in effect.
Temporary FMAPs in effect for FY 2020 – FY 2021 = 76 for Puerto Rico, 83 percent for other ... [Read More]
Year
Legislative milestones or key provisions
1965
Medicaid, an individual entitlement with federal-state financing, is enacted as Title XIX of the Social Security Act (the Act, P.L. 89-97) to provide health coverage for certain groups of low-income people. Title XIX:
links Medicaid eligibility to receipt of Aid to Families with Dependent Children (AFDC) for families with dependent children under ... [Read More]