State Strategies to Compensate Beneficiary Advisory Council Members

The Issue

The Ensuring Access to Medicaid Services final rule requires states to create and support a Beneficiary Advisory Council (BAC) as well as a Medicaid Advisory Committee (MAC), which together are intended to create a more formalized way for enrollees and interested parties to provide bidirectional feedback to the state about the Medicaid program. This issue brief offers considerations for determining how to fairly compensate BAC members for their time and expertise without adversely affecting their eligibility for Medicaid.

Key Findings

• Compensation provided to enrollees for participation in the BAC and MAC should acknowledge the time, input, and effort that individuals are contributing and reflect the value of their expertise.
• To promote equity, states should consider offering a combination of compensation types and mechanisms for compensation, allowing for flexibility to meet enrollees’ needs and preferences.
• For enrollees eligible for Medicaid on the basis of Modified Adjusted Gross Income (MAGI), higher taxable income may affect their eligibility for Medicaid. States should carefully approach compensation in the form of direct monetary stipends for MAGI enrollees serving on the BAC and the MAC. 

Conclusion

States should discuss with potential BAC members the type(s) and amount of compensation that will be offered, the types of BAC activities for which enrollees will be compensated, potential impacts on coverage if compensation is accepted, and flexibility to modify compensation to maintain coverage. Thoughtful design and dialogue on compensation will further promote partnership between states and community members that will serve to strengthen and improve the Medicaid program for all enrollees.

About State Health and Value Strategies

State Health and Value Strategies (SHVS) assists states in their efforts to transform health and healthcare by providing targeted technical assistance to state officials and agencies. The program is a grantee of the Robert Wood Johnson Foundation, led by staff at Princeton University’s School of Public and International Affairs. The program connects states with experts and peers to undertake healthcare transformation initiatives. By engaging state officials, the program provides lessons learned, highlights successful strategies, and brings together states with experts in the field. Learn more at www.shvs.org.

About Manatt Health

Manatt Health, a division of Manatt, Phelps & Phillips, LLP, is an integrated legal and consulting practice with over 160 professionals in nine locations across the country. Manatt Health supports states, providers, and insurers with understanding and navigating the complex and rapidly evolving healthcare policy and regulatory landscape. Manatt Health brings deep subject matter expertise to its clients, helping them expand coverage, increase access, and create new ways of organizing, paying for, and delivering care. For more information, visit www.manatt.com/health.