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
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 […]
Federal Survey Sample Size Analysis: Disability, Language, and Sexual Orientation and Gender Identity
October 11, 2023
The Medicaid and CHIP Payment and Access Commission contracted with State Health Access Data Assistance Center (SHADAC) to conduct a review and sample size analysis of 13 federal population health surveys. The review identified which surveys included questions about disability, primary language, limited English proficiency (LEP), and sexual orientation and gender identity (SOGI). The sample […]