Billy Wynne

Commissioners Discuss I-SNPs for Long-Stay Nursing Home Residents The Medicare Payment Advisory Commission (MedPAC) held a meeting to discuss Institutional Special Needs Plans (I-SNPs). This was the second of three sessions this meeting cycle focused on long-stay nursing home residents, the first of which was an overview of the workplan in October 2024 (Impact summary). Chair Michael Chernew…

National Governors Association Releases Statement on Potential Medicaid Cuts  Today, the National Governors Association (NGA)  released a statement expressing concern regarding Medicaid cuts that are currently being considered in Congress as part of Budget Reconciliation.  The statement is from NGA Chair Governor Polis (Colorado) and NGA Vice Chair Governor Stitt (Oklahoma) on behalf of the…

CMS Rescinds Guidance on Medicaid and CHIP Coverage of Health-Related Social Needs (HRSNs);  Annouces Plans to Review Waivers on a Case-by-Case Basis in the Future On March 4, the Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin (CIB) rescinding CMS’ previous 2023 and 2024 guidance on Medicaid and Children’s Health Insurance Program (CHIP) coverage of…

President Trump’s Executive Order Calls for Sweeping Review of Government Contracts and Grants President Trump issued an Executive Order (EO) titled “Implementing the President’s ‘Department of Government Efficiency’ Cost Efficiency Initiative.” This order mandates a comprehensive 30-day review of federal contracts, grants, and loans with the aim of reducing federal spending and reallocating funds to…

Task Force Announces Draft Research Plan for Tobacco Cessation Interventions in Adults; Comments Due March 26 The U.S. Preventive Services Task Force (USPSTF) released a draft research plan on interventions for tobacco cessation in adults. This research plan aims to assess the effectiveness and potential harms of various tobacco cessation methods, including their impact on…

Commissioners Discuss the Use of AI for Medicaid Prior Authorization The Medicaid and CHIP Payment and Access Commission (MACPAC) held a meeting to discuss automation and artificial intelligence (AI) in the prior authorization (PA) process. Commissioners were excited about the potential of AI to streamline PA but have concerns about bias and denials without proper clinical oversight.…

Commissioners Reassess and Recommit to Improving Health Care for Foster Children The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to revisit how Medicaid meets the unique health care needs of children in foster care, building on its 2015 examination of the intersection between Medicaid and child welfare. The session involved a…

Commissioners Explore Challenges and Opportunities in Self-Directed Home and Community-Based Services The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to explore interview findings on program design and administration of self-directed services in Medicaid Home- and Community-Based Services (HCBS), which allow individuals with long-term care needs to live independently in their communities.…

Commissioners Support Draft Policy Recommendations Focused on the Challenges of Transitions of Care for Children and Youth with Special Health Care Needs The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to present draft policy options aimed at addressing the challenges faced by children and youth with special health care needs (CYSHCN)…

Health Subcommittee Reexamines PBM Reform; Democrats Focus on Impact of Potential Medicaid Cuts The Energy and Commerce (E&C) Health Subcommittee convened a hearing to examine pharmacy benefit manager (PBM) practices and discuss bipartisan reform efforts. The following witnesses spoke to certain PBM practices that inhibit the ability of patients, pharmacies, and employers to obtain affordable…