The Medicaid and CHIP Payment and Access Commission's (MACPAC) March 2018 Report to Congress examines three aspects of Medicaid policy: managed care, telehealth, and disproportionate share hospital (DSH) payments. First, MACPAC proposes statutory changes to allow states to require all beneficiaries to enroll in Medicaid managed care programs, along with changes to Section 1915(b) waiver authority to make it easier for states to select managed care as their delivery system. Second, MACPAC discusses the current authority of states to cover telehealth services, with a focus on the application of telehealth to oral health, behavioral health, maternity care, and high-need populations. Finally, MACPAC includes a statutorily-mandated analysis of DSH policy, noting that it observes "no meaningful relationship" between state DSH allotments and potential indicators of the need for DSH funds (e.g., changes in the number of uninsured individuals; the amounts and sources of hospitals' uncompensated care costs; and the number of hospitals with high levels of uncompensated care that also provide essential community services for low-income, uninsured, and vulnerable populations).
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