Checklist for State Advocates

The Centers for Medicare & Medicaid Services (CMS) finalized a rule in May 2024 that sets new standards for state agencies to better engage Medicaid enrollees and their families in the Medicaid decision-making process through implementation of Medicaid Advisory Committees (MACs) and Beneficiary Advisory Councils (BACs). As states create their MACs and BACs, state advocates can start now to promote transformational engagement with Medicaid enrollees and their families and caregivers, so that their experiences inform state policy decisions. Advocates can use this checklist as a quick reference and get more detailed information here.

 Share Best Practices as Committees Are Established

Informing the State’s Recruitment and Selection Process

• Offer ideas about outreach and communications strategies to recruit potential BAC members.
• Help disseminate announcements about the state’s recruitment and selection process.
• Make recommendations on how to promote language access in the process.

Participating in the Process of Structuring the Committees

• Recommend a meeting cadence that limits burden on BAC members.
• Advocate for multi-year term lengths to allow BAC members more time to get comfortable with sharing their thoughts and build relationships and trust.
• Provide feedback on the list of topics that can be covered in the committees.

Giving Recommendations on How the State Provides Financial Support for BAC Members

• Provide input on how the state determines who needs financial support and how compensation is calculated.
• Ensure the state’s method of providing financial support does not negatively impact enrollees’ eligibility for Medicaid and other benefit programs.

 Participate in MAC Meetings

• Join the MAC as a representative of a state or local consumer advocacy organization.
• If not a MAC member, attend MAC meetings when they are open to non-members.

 Identify Potential BAC Members

• Refer people to the state agency’s recruitment team for the BAC by using your organization’s existing networks.

 Provide Support to Members of the BAC

• Help make enrollees aware of accessibility supports, including disability accommodations, they should be provided to facilitate their participation in the BAC.
• Share best practices with the state for conducting accessible meetings (e.g., making materials available in multiple formats, sending translated materials ahead of time, ensuring accessible physical spaces for in-person meetings).
• Provide policy and research support to BAC members, providing them with objective information on technical issues as they develop their own recommendations.

 Identify Financial Resources to Support Your Organization’s Work Related to MAC and BAC

• Have initial conversations with funders about why advocacy organizations’ work is necessary to make sure these committees are set up to meaningfully engage people with lived experience and to provide BAC members with adequate support to participate.

 Help Hold States Accountable to New Requirements

Raise any concerns about not meeting requirements directly with the state agency or with CMS.

Participate in the process of creating MAC and BAC bylaws to proactively promote transparency.

Monitor how well the state is meeting requirements around transparency (e.g., reporting on how they are responding to MAC and BAC recommendations), accessibility, and representation on the committees.