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Critics worry about state, federal conflicts
Federal efforts to exert more control over the Medicaid and Medicare programs have providers hoping to eventually see an increase in federal reimbursement for the programs, although some are concerned these efforts may lead to increased federalization of public health insurance.
A new federal advisory commission - the Medicaid and CHIP Payment and Access Commission, or MACPAC- is being assembled and is supposed to review and assess payment policies for Medicaid and die State Children's Health Insurance Program. Separately, an influential member of Congress - Sen. Jay Rockefeller (D-W.Va.), who chairs the Senate Finance Committee's health subcommittee^ - recently floated the idea of giving more power to the Medicare Payment Advisory Commission, which currently makes recommendations only on Medicare.
MACPAC could raise what hos- pital officials believe now is meager Medicaid reimbursement. "It offers a new opportunity to examine reimbursement rates" in Medicaid and SCHIP, a major issue for providers, particularly physicians, said MoIJy Collins Offner, director for policy development with the American Hospital Association.
"I think the new commission will be a big contribution to the policy arena, to healthcare reform and to the operation of these programs," Collins Offner said.
The formation of this panel is still in the early stages. Although its first reports to Congress are due early next year, commission members have yet to be appointed by the Government Accountability Office, which also has jurisdiction over appointments to MedPAC. The new commission "has its work cut out for it. It's going to take a while before it becomes established," said Bruce Steinwald, a GAO healthcare director.
Some providers and patient advocacy groups see MACPAC as a welcome development.
Both advisory panels - MACPAC and...