June 23, 2021

MACPAC Releases June Report to Congress

The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) released its June Report to Congress June 15. This report includes chapters that address: high-cost specialty drugs; access to mental health services for adults, children and adolescents, and the integration of physical and behavioral healthcare through electronic health records; the non-emergency medical transportation benefit in Medicaid; and state strategies for integrating care for people who are dually eligible for Medicaid and Medicare.

The commission made several recommendations, including two pertaining to high-cost drugs in Medicaid. The commission:

  • Recommends Congress increase the minimum rebate percentage on drugs approved by the U.S. Food and Drug Administration (FDA) through the accelerated approval pathway until the manufacturer has verified the clinical benefit.
  • Recommends an increase in the additional inflationary rebate on drugs that receive approval from the FDA through the accelerated approval pathway. Once the FDA grants traditional approval, the Medicaid rebates would revert to the standard amounts.

The final chapter of the report continues the MACPAC’s work on integrating care for individuals who are dually eligible for Medicaid and Medicare. The commission is exploring ways that states can better integrate care through Medicare Advantage dual-eligible special needs plans using existing contracting authority. The commission recommended additional resources to help states design and implement integrated care models.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the secretary of the U.S. Department of Health and Human Services and the states on a wide array of issues affecting Medicaid and CHIP. The MACPAC is required to submit reports by March 15 and June 15 each year.

If you have questions regarding the MACPAC June Report to Congress or the American College of Radiology® Medicaid Network, please contact Christina Berry at cberry@acr.org or Alicia Blakey at ablakey@acr.org.