MACPAC calls for work rule monitoring and human review of AI denials
Issue
In its June 2026 report, MACPAC, Congress's Medicaid advisory commission, voted 15-2 to urge CMS to publish a plan to monitor H.R. 1 work requirements before January 1, 2027.
It also recommends that a human with clinical expertise review every adverse Medicaid prior authorization decision, so automation alone cannot deny a request.
Sources for this story
MACPACPart of
- Medicaid work-requirement implementation
The federal rule (CMS-2454-IFC)
- AI in care: law, oversight and adoption
Federal oversight and standards
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FQHC Talent. (2026, June 10). MACPAC calls for work rule monitoring and human review of AI denials. Source: MACPAC. Retrieved November 11, 2026, from https://www.fqhctalent.com/intel/macpac-june-2026-report-work-req-monitoring-ai-prior-auth