MACPAC June Report Examines Medicaid Third Party Liability

As announced by the Medicaid and CHIP Payment and Access Commission (MACPAC):

“The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2020 Report to Congress on Medicaid and CHIP, which this year addresses how to improve integration of care for dually eligible beneficiaries who have both Medicaid and Medicare coverage; increasing enrollment in the Medicare Savings Programs (MSPs) that use Medicaid funds to cover certain Medicare costs for low-income beneficiaries; Medicaid’s role in maternal health; and ensuring that Medicaid remains the payer of last resort when beneficiaries have other sources of coverage. The report includes five recommendations for congressional and administrative action.

In the Commission’s letter transmitting the report to Congress, MACPAC Chair Melanie Bella said that much of the report reflects work completed in advance of the COVID-19 pandemic while noting that’“…concerns about how best to serve the high-cost high need population enrolled in both Medicare and Medicaid, as well as low-income pregnant women, among others, may even be of heightened importance at this time.’

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In Chapter 4, the Commission turns to another ongoing challenge in Medicaid: protecting the safety-net program’s statutory role as the payer of last resort. This is important because ensuring payment from the appropriate party helps preserve Medicaid funds to cover services for beneficiaries and limits cost shifting to states and the federal government, a concern that will be even more pressing in light of declining state revenues. Chapter 4 looks specifically at third-party liability coordination with TRICARE, the health insurer for U.S. Armed Forces military personnel, military retirees, and their dependents, almost 900,000 of whom also have Medicaid coverage. Chapter 4 contains two recommendations to keep Medicaid from bearing costs that are the responsibility of the Department of Defense.”