Medicaid Advisory Committees & Beneficiary Advisory Councils

For decades, the regulations at § 431.12 required States to have a Medical Care Advisory Committee (MCAC) to advise the State Medicaid agency about health and medical care services.  These regulations were intended to ensure that State Medicaid agencies had a way to receive feedback regarding health and medical care services from interested parties.  However, these regulations lack specificity related to how these committees can be used to ensure the proper and efficient administration of the Medicaid program more expressly by more fully promoting beneficiary perspectives.

On April 22, 2024, CMS published  “Ensuring Access to Medicaid Services (CMS-2442-F)” (Access Final Rule, CMS 2442-F), effective July 9, 2024. This final rule takes a comprehensive approach to improving access to care, quality, and health outcomes, and better addressing health equity issues in the Medicaid program across fee for service (FFS), managed care delivery systems, and in home and community-based services (HCBS) programs.

Section II.A. of the Access Final Rule updates § 431.12 to replace the current MCAC requirements with a committee framework designed to ensure the proper and efficient administration of the Medicaid program and to better ensure that services under the Medicaid program will be provided in a manner consistent with the best interests of the beneficiaries. These updates include:

• Renaming and expanding the scope of states’ Medical Care Advisory Committees. The renamed Medicaid Advisory Committees (MAC) will advise states on an expanded range of issues.
• Requiring states to establish a Beneficiary Advisory Council (BAC) comprised of Medicaid beneficiaries, their families, and/or caregivers. 
• Establishing minimum requirements for MAC membership, including a requirement that 25% of the MAC members will be drawn from the BAC.
• Requiring states to make information about the MAC and BAC activities publicly available including bylaws, meeting schedules, agendas, minutes, and membership lists. 
• Requiring states to make at least two MAC meetings per year open to the public. These meetings must include a public comment period. 
• Requiring states to provide staff to support the planning and execution of the MAC and BAC activities. 
• Requiring states to create and publicly post an annual report summarizing MAC and BAC activities. 

A general summary of key Medicaid Advisory Committee & Beneficiary Advisory Council provisions  were presented on the July 16, 2024 Medicaid and CHIP All State Call.

For questions about Medicaid Advisory Committee & Beneficiary Advisory Council provisions email: MedicaidAccess_MACBAC@cms.hhs.gov