MACPAC’s June 2026 Report to Congress on Medicaid and CHIP contains seven chapters of interest to Congress: (1) community engagement (CE) requirements in Medicaid, (2) automation in prior authorization (PA), (3) Medicaid managed care accountability, (4) appropriate access to residential treatment services for Medicaid-enrolled youth, (5) transitions to adult Medicaid coverage for children and youth with special health care needs (CYSHCN), (6) the Program of All-Inclusive Care for the Elderly (PACE), and (7) provider enrollment and credentialing in Medicaid.
Chapter 1 contains a recommendation to create a transparent plan for monitoring and evaluating CE requirements in Medicaid.
Chapter 2 focuses on automation in Medicaid PA and makes recommendations to address the risks posed by automation tools, strengthen oversight, and increase disclosure and transparency of managed care plans’ use of automation in PA.
Chapter 3 offers recommendations to improve managed care plan accountability.
Chapter 4 makes recommendations aimed at improving appropriate access to residential behavioral health treatment for Medicaid-enrolled children and youth.
Chapter 5 contains recommendations to ease the transition to adult Medicaid coverage for CYSHCN.
Chapter 6 makes recommendations aimed at improving coordination on audits, making existing PACE performance information publicly available, and developing a standard national quality measure set for PACE organizations.
Chapter 7 looks at Medicaid provider enrollment and managed care credentialing, which is designed to ensure that Medicaid enrollees receive care from qualified providers.
Chapters:
- Implementing Community Engagements Requirements in Medicaid
- Automation in Medicaid Prior Authorization
- State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Plans
- Addressing Appropriate Access to Residential Behavioral Health Treatment for Children in Medicaid
- Children and Youth with Special Health Care Needs Transitions to Adult Coverage
- Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly
- Provider Enrollment and Credentialing in Medicaid