Findings from MACPAC’s work demonstrate that Medicaid-covered children and youth with special health care needs can have challenges with the transition from child to adult Medicaid and may experience a gap or loss in coverage during this period. This session provided a summary of the interview and 2023 Transformed Medicaid Statistical Information System (T-MSIS) findings, key challenges, and current CMS requirements and guidance related to these challenges. MACPAC staff presented seven policy options for Commissioner consideration to address these findings.