The Commission continued its discussion on a new approach for monitoring access to care for Medicaid beneficiaries. In this session, staff presented a draft chapter with a package of five recommendations for a new access monitoring system. The chapter discusses the challenges and limitations of the current monitoring approach, the goals and key elements for a new system, and the rationale and implications for Commission recommendations. The chapter draws from Commission discussions, findings from expert panels and key stakeholder interviews, and a review of the literature and stakeholder comments on access rules.