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Program Administration

The Centers for Medicare & Medicaid Services (CMS) and the individual states and territories jointly administer Medicaid and the State Children’s Health Insurance Program (CHIP). CMS is responsible for program administration at the federal level. CMS approves state plans and state plan amendments, waivers, and demonstration programs; enforces compliance; and provides guidance to states.

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Featured Publications

Medicaid Work Requirements: Monitoring State Implementation

October 29, 2026

The Commission is monitoring four key areas of implementation in Medicaid work requirements: state readiness, medical frailty, beneficiary outreach, and federal and state reporting. This session summarized key findings from publicly available information and stakeholder interviews on each of four monitoring areas, highlighted early data on work requirements from Nebraska, and discussed updates on CMS […]

Comment Letter: Proposed Redesign of the National Health Interview Survey

October 19, 2026

In a letter to the Centers for Disease Control and Prevention (CDC), MACPAC commented on the CDC’s notice with comment period on the systemic redesign of the National Health Interview Survey (NHIS) to be implemented in 2028.  The Commission’s comments focus on the important role of national health survey data in understanding the experiences of […]

State Medicaid Enterprise Systems

July 28, 2026

Information technology (IT) systems are an essential tool in administering a modern state Medicaid program. This brief provides information regarding the Medicaid program functions that are supported by IT, details spending on the systems, discusses federal oversight of the systems projects, and highlights challenges for Medicaid IT systems.
The IT systems that support a state’s Medicaid […]