Medicaid Advisory Committee (MAC) and Beneficiary Advisory Committee (BAC): Bylaws

Article 1 – Authority

The Medicaid Advisory Committee (MAC) and the Beneficiary Advisory Committee (BAC) were created by the Minnesota Department of Human Services (DHS). DHS created the MAC and BAC because of a federal law, number is 42 CFR §431.12. This law says that states need to create a MAC and BAC to give advice to the Medicaid Director. The Medicaid Director is the person who works at DHS and leads the Medicaid program in Minnesota. In Minnesota, Medicaid is often called Medical Assistance.

These committees give advice about what DHS should do, and don’t make rules or laws.

Article 2 – Guiding Principles

The MAC and BAC have guiding principles, which are something that a group agrees is important. They think about these guiding principles when they make decisions, and these principles guide how the MAC and BAC work. They focus on fairness, community input, honesty, and using real data to make better decisions.

The guiding principles for the MAC and BAC are:

People who are on Medicaid help lead the MAC and BAC.
Equity is important. Health care and services should treat people fairly. Care should respect people’s cultures and languages.
People from the community participate in the MAC and BAC. They participate in a way that makes a difference.
The MAC and BAC are honest and responsible. They share information with the public.
Research and data are used when making policies.
Communities and DHS work together to solve problems.

Article 3 – Membership

Section 1 – MAC Membership

15 to 20 people will be on the MAC.

People on the MAC will have many different backgrounds. Some will be people on Medicaid. The MAC can also include people from organizations that work with people on Medicaid. Some examples of these organizations are:

School-based health centers
County and local government agencies
Disability organizations
Providers that work with older adults
Home care and waiver service providers
Interpreter and language access organizations
Tribal health organizations
Organizations who work with people who are homeless
Veterans' organizations
Foster care systems
Community organizations that help people with social needs
Medical-legal partnerships
Other organizations that advocate or give services to people on Medicaid

Section 2 – BAC Membership

12 to 18 people will be on the BAC. The people who can be on the BAC are:

People who are on Medicaid
People who have been on Medicaid in the past
Family members or caregivers of people who are on Medicaid

Both adults and youth can be on the BAC. Youth need their guardian’s permission to participate.

It is important that the BAC is diverse. People on the BAC should have different experiences and identities. This includes differences in:

What part of the state they live in
Race and ethnicity
Age group
Gender and sexual orientation
If they have a disability
If they use language interpreters or have other language needs
The health care experiences they have had

DHS will prioritize people with certain experiences when they choose who will be on the BAC. This includes people who:

Are on both Medicaid and Medicare
Get waiver services
Are on Medical Assistance for Employed Persons with Disabilities (MA-EPD)
Need a lot of medical care
Need a lot of support with mental health or behavior
Are immigrants or refugees
Don’t speak a lot of English
Have been a foster youth
Have lived in a group home or in other housing where many people with disabilities or seniors live in the same building and get services

Article 4 – Committee Structure

Section 1 – Governance Model

The MAC and BAC follow three steps to make recommendations.

First, the BAC talks about a topic. They come up with recommendations for new steps DHS can do. They also come up with changes DHS can make to the Medicaid program. The BAC thinks about how something would affect people on Medicaid. This makes sure community voices are heard before decisions are made.

After the BAC talks about an idea, the MAC talks about it. The MAC thinks about how something would affect people on Medicaid. They also think about how it would affect providers and other partners.

Then, DHS and the Medicaid director look at what the MAC and BAC recommended. They respond to the MAC and BAC about their recommendations.

Following these steps means that people in the community can share their experiences. Then DHS uses what they share to develop policies. These steps also create a clear process for making decisions.

Section 2 – Relationship Between BAC and MAC

The MAC and BAC work together.

The BAC gives input on:

The perspectives of people on Medicaid
How to make policy better for people on Medicaid
Accessibility of the Medicaid program
Communication about Medicaid

The MAC gives input on:

The perspectives of people and organizations affected by Medicaid
The impact that policies will have
How organizations should act on policies
How the Medicaid program should run

Some people will only serve on the BAC. Some people will only serve on the MAC. Some people will serve on both committees. At least 25% of people on the MAC should be from the BAC. This matches the rules in federal law.

People from the BAC who join the MAC have the same rights as other MAC members. They can vote on decisions in the same way as other MAC members.

Article 5 – Purpose and Responsibilities

The MAC gives advice to the Medicaid Director. They give advice about how Medicaid should run and about policy. They also give input on how well the Medicaid program is working.

The BAC also gives advice to the Medicaid Director. They give advice from the perspective of people on Medicaid.

Some of the topics that the MAC and BAC give advice about are:

Changes to services
How people apply for Medicaid
The information that DHS and health care plans send to people on Medicaid and to providers
Making the Medicaid program more equitable for different groups of people
Changes to how providers get paid
How well the Medicaid program and Medicaid services are working
Changes to laws or rules that affect Medicaid
How easy it is to get Medicaid services
Other topics that affect health care services for people on Medicaid

Both the MAC and BAC give advice on those topics.

There are other topics that only the BAC gives advice about. Some of the other topics that the BAC gives advice about are:

How policy changes will affect people on Medicaid
How to help people navigate Medicaid
Sharing personal experiences with Medicaid
How DHS and the community can work together to solve problems
How DHS can hear more input from people in the community

DHS will help people in the BAC learn new skills. People on the BAC will be able to learn more about Medicaid policy and how Medicaid is run. They do not need know this to be a BAC member

Article 6 – Policy Workgroups

The MAC and BAC can form workgroups. Workgroups focus on specific topics.

Different people can be on the workgroups. This can include:

MAC members
BAC members
People from the community
Experts in a topic
People who work at a state agency

Workgroups can focus on different things. Examples of workgroup topics include:

Making services better for people from different cultures or who speak different languages
How people get on Medicaid and who is allowed to get it
Health equity and helping all people live healthy lives
Services for people with disabilities and older adults
Child and family health
Health of people who are pregnant
Giving advice about new laws

Article 7 – Selection and Appointment

People can apply to be on the MAC and BAC. The BAC will then choose several members to join the MAC.

People who apply will be interviewed before they join the MAC or BAC. There might also be a group who review at everyone’s applications.

The Medicaid Director will decide who gets chosen to be on the MAC and BAC. The Medicaid Director can also give a different person permission to decide who will be on the MAC and BAC. This is called a designee.

The Medicaid Director or their designee will prioritize people who:

Have diverse experiences
Live in different parts of the state
Have experiences using Medicaid services
Can contribute to discussions
Have time to come to meetings

Article 8 – Terms of Service

MAC members will be on the MAC for at least two years. After two years, they can choose to stay for two more years. The longest someone can be on the MAC is four years.

BAC members will be on the BAC for at least two years. After two years, they can choose to stay for one more year. The longest someone can be on the BAC is three years.

When someone leaves the MAC or BAC, a new person will replace them. DHS can get new applications from people or ask a specific person to replace them.

The way someone is chosen doesn’t change how long they can stay on the MAC or BAC. All new MAC members can stay for either two or four years. All new BAC members can stay for either two or three years. They can stay that long even if they are replacing someone else.

Article 9 – Officers

The MAC and BAC will have officers. Officers have extra responsibilities. MAC and BAC members will vote for these officers.

The officers are:

Chair
Vice Chair

Two people can chair each committee. For example, the MAC or BAC could choose to have two people who are co-chairs. They would work together to be the chair of the committee.

At least one officer for the MAC needs to be a BAC member. The officers’ responsibilities are to:

Lead meetings
Make agendas
Tell DHS what the committees decide

DHS and consultants can help the officers with their responsibilities.

Article 10 – Meetings

Meeting Frequency

The MAC will meet between four and six times a year.

At least two MAC meetings a year will be public. Anyone can watch public MAC meetings. During public MAC meetings, there will be time for public comment. People who are not on the MAC can share their thoughts and opinions during that time.

The BAC will meet at least four times a year. BAC meetings will not be public unless the BAC votes to make a meeting public.

Meeting Format

MAC and BAC meetings can be in-person or virtual. MAC and BAC meetings can also be hybrid. At hybrid meetings, some people are there in person, and some people are there virtually.

DHS will make sure the meetings are as accessible as possible.

Article 11 – Accessibility and Participation Supports

DHS will offer reasonable accommodations to help people participate. These accommodations can include:

Language interpretation
Disability accommodations
Accessible meeting materials
The option to join meetings virtually
Any other reasonable accommodations requested

DHS will offer other things to help people participate. These include:

Getting paid a stipend
Help with childcare during meetings
Help with technology so you can join meetings

Article 12– Decision-Making

The MAC and BAC give advice and recommendations.

Sometimes everyone will agree on an idea. Then that idea will become a recommendation.

Sometimes not everyone will agree. Then the group can vote. If most of the group votes for the idea, it will become a recommendation.

If a MAC or BAC member doesn’t agree with a recommendation the group votes for, they can share their opinion. DHS will write down what they say or record it. DHS will share the recommendation with the Medicaid Director. The recommendation will say that most of the group agreed but some did not. They will share the reasons why some people didn’t agree.

Article 13 – Transparency

DHS will share information about the MAC and BAC with the public. This helps people know what the MAC and BAC are doing.

DHS will publicly post:

Lists of who is on the MAC and BAC
The days and times the meetings happen
Meeting agendas
Summaries of what happened at meetings

There will sometimes be meetings where people from the public can come and share input.

Article 14 – Orientation and Training

DHS will share information about some topics to the MAC and BAC members. These topics will include:

How the Medicaid program runs
The MAC and BAC’s responsibilities
Making health care more fair for different groups of people
How to work with people from different cultures or who speak different languages
Rules about keeping information private
How policies are made

Article 15 – Amendments

The MAC and BAC can recommend that DHS change these bylaws. DHS can also change these bylaws. DHS will ask the MAC and BAC for input if it wants to make changes. DHS will tell MAC and BAC members about any changes before they officially happen.