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.
Learn More about These Topics
- Medicaid administrative data
- Payment Error Rate Measurement (PERM)
- State plan
- Waivers
- Program integrity
Featured Publications
Provider Enrollment and Credentialing in Medicaid
March 5, 2026
Medicaid provider enrollment and managed care credentialing aim to ensure that Medicaid enrollees receive care from qualified providers. As part of the Commission’s continued focus on access to care for Medicaid enrollees, MACPAC examined federal and state policies as well as academic and grey literature pertaining to Medicaid provider enrollment and credentialing. In this session, […]
Automation in the Prior Authorization Process
February 27, 2025
Recent years have seen growth in the use of technology, including artificial intelligence (AI), to automate parts of the Medicaid prior authorization process. However, there is little information available today about how automation is used in Medicaid prior authorization and its impact on payers, providers, and Medicaid beneficiaries. To fill this gap in knowledge, staff […]
Testimony: Hearing on Improper Payments and Ensuring Program Integrity
April 16, 2024
On April 16th, MACPAC Commissioner Tim Hill testified before the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations for a hearing on improper payments in Medicare and Medicaid.
Ensuring program integrity (PI) in Medicaid is important given the program’s role as a key safety net program, serving 94 million beneficiaries in fiscal year 2022 […]