In its biannual report to Congress, published on the statutory June 15, 2026 deadline, the Medicaid and CHIP Payment Access Commission (MACPAC) over seven chapters addresses a range issues relevant to providers, including Medicaid prior authorization (PA) and automation, Program of All Inclusive Care for the Elderly (PACE) program quality measures, and community engagement requirement implementation.

MACPAC commissioners are tasked with providing nonpartisan recommendations to the administration and Congress on Medicaid policies and payments, supported by staff researchers who develop recommendations to improve Medicaid efficiency, economy, and quality.

The first chapter focuses on the implementation of community engagement requirements from HR 1, making the case for timely guidance to states from the Centers for Medicare and Medicaid Services (CMS) and greater public data transparency at the state level as requirements are communicated and deployed.

Chapter two addresses the use of PA in Medicaid and urges increased state oversight of prior authorization use and improved disclosure of use by managed care organizations—leading fittingly into into the third chapter on state and federal tools for ensuring accountability of Medicaid managed care plans. The commission seeks to better understand managed care plan performance data and identify stronger mechanisms to hold plans accountable for fulfilling contract obligations.

Chapters four and five focus on populations and services beyond the normal scope of members.

In the sixth chapter, commissioners and staff note that PACE programs provide extensive data to CMS, though no data is publicly available for assessing PACE programs–spurring the commission’s request  that the agency publish already submitted data and develop PACE-specific quality measures to support benchmarking and comparison of programs across geographies. Additionally, MACPAC directs CMS to consider ways to align state and federal audits to reduce duplication of effort and administrative burden on all parties.

Chapter seven assesses states’ approaches to provider enrollment and credentialing and how policies contribute to administrative burden on states and providers, as well as the respective impacts on program integrity.

While MACPAC reports are non-binding and informational-only, the attention of commissioners and staff to these areas is both welcome and timely. The MACPAC press release on the report’s release is here and the full report is available here.