The Medicaid and Chip Payment Access Commission (MACPAC), a nonpartisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP), on March 13 released the first to two reports that it is statutorily obligated to deliver to Congress. 

The 100-plus pages of analysis and recommendations included in MACPAC’s March 13 transmission cover a range of topics. Chapter One addresses the role of External Quality Reviews (EQR), which are mandatory in Medicaid Managed Care programs. Commissioners recommended more tangible and quantitative data in reports from the EQR organization on managed care program performance.

Chapter Two covers timely access to home and community-based services (HCBS) and explores the use of expedited or presumptive eligibility procedures for individuals applying for HCBS and flexibilities on provisional plans of care to reduce the time from enrollment to initial care receipt.

The third chapter discusses the administrative burden on states to administer some waiver authorities as required by the Centers for Medicare and Medicaid Services (CMS) in state applications, renewals, and technical assistance with CMS.

Reports transmitted from MACPAC to Congress typically include in recommendations for policy changes within the Centers for Medicare and Medicaid (CMS). MACPAC’s research is intended to inform policy making, though has no authority to impose action. In this report, the policy recommendations would impose additional regulatory authority to CMS and ease access to services. The current administration has taken a position in which costs and regulation need to be trimmed not expanded.

The full report can be reviewed here. The next MACPAC report is scheduled for a June 2025 delivery.