HomeMy WebLinkAboutIdaho_BAC_Bylaws_FINAL_Signed_11192025November 2025
IDAHO MEDICAID BENEFICIARY ADVISORY COUNCIL (BAC)
Bylaws
ARTICLE 1. NAME AND LOCATION
Section 1. The name of the council shall be the Idaho Medicaid Beneficiary Advisory
Council (BAC).
Section 2. The principal office of the BAC shall be located within the Idaho
department of Health and Welfare, Division of Medicaid, 450 West State Street,
Boise, Idaho, 83702-6056.
ARTICLE 2. LEGAL AUTHORITY
Section 1. Section 1902(a)(4) of the Social Security Act, as implemented in 42 CFR
431.12, requires states to maintain a BAC to advise the state Medicaid program on
health and medical care services and participate in policy development and program
administration. Specifically, “The State plan must provide for a (…) BAC that will
advise the director of the single State Agency for the Medicaid program on matters of
concern related to policy development and matters related to the effective
administration of the Medicaid program” 42 CFR 431.12(b).
ARTICLE 3. AUTHORITY TO ESTABLISH THE BENEFICIARY ADVISORY COUNCIL
Section 1. The authority to appoint members to the BAC is vested in the Medicaid
Director within the Idaho Department of Health and Welfare (department).
Section 2. The BAC is established as a condition for receiving federal funding under
the Medicaid program, as mandated by federal regulations.
ARTICLE 4. PURPOSE
Section 1. The purpose of the BAC is to:
A. Advise the Medicaid Director and the department on policies and programs
that affect Medicaid beneficiaries.
B. Review the quality, access, and availability of services provided to Medicaid
beneficiaries and recommend changes or improvements.
C. Serve as a bridge between Medicaid beneficiaries and the Medicaid program,
facilitating feedback from the beneficiaries to the department.
D. Assist in the identification of gaps in services, barriers to access, and unmet
needs within the Medicaid population.
E. Promote the interests of Medicaid beneficiaries in a fair and impartial
manner, ensuring that the Medicaid program addresses their needs.
F. Participate in discussions of Medicaid program changes, including eligibility,
benefits, quality of care, and any new policies or initiatives impacting
beneficiaries.
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ARTICLE 5. FUNCTION
Section 1. The Code of Federal Regulation, CFR 431.12 (g), states:
“The MAC and BAC participants committee must have the opportunity to advise the
director of the single State Agency for the Medicaid program on matters related to
policy development and matters related to the effective administration of the
Medicaid program.
At a minimum, the MAC and BAC must determine, in collaboration with the State,
which topics to provide advice on related to-
(1) Additions and changes to services;
(2) Coordination of care;
(3) Quality of services;
(4) Eligibility, enrollment, and renewal processes;
(5) Beneficiary and provider communications by State Medicaid agency and Medicaid
MCOs (Managed Care Organization), PIHPs (Prepaid Inpatient Health Plans), PAHPs
(Prepaid Ambulatory Health Plan), PCCM (Primary Care Case Management) entities or
PCCMs as defined in § 438.2;
(6) Cultural competency, language access, health equity, and disparities and biases in
the Medicaid program;
(7) Access to services; and
(8) Other issues that impact the provision or outcomes of health and medical care
services in the Medicaid program as determined by the MAC, BAC, or State.”
Section 2. The functions of an "advisory council" are to advise and make
recommendations to the department.
ARTICLE 6. COMPOSITION
Section 1. The BAC shall be composed of a minimum of seven (7) and up to fifteen
(15) members. Members shall reflect the diversity of Medicaid beneficiaries and their
communities.
Section 2. At least twenty-five (25) percent of the Medicaid Advisory Committee (MAC).
must be composed of BAC members by July 10, 2027, per federal code. The BAC may
designate up to five (5) representatives to attend and represent the BAC at MAC
meetings. BAC representative to the MAC Meetings must hold this role for a period of
at least one (1) year (e.g. representing the BAC at the MAC meetings).
Section 3. BAC members shall include representation from Medicaid beneficiaries
and/or their family members/caretakers.
ARTICLE 7. MEMBERSHIP AND APPOINTMENT
Section 1. Members of the BAC shall be appointed by the Medicaid Director.
Section 2. Appointments shall be for three-year terms.
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Section 3. The appointment process shall be staggered to ensure continuity of
membership. The department shall solicit recommendations for appointments from
advocacy groups, community organizations, and existing BAC members.
Section 4. The BAC shall have a procedure that encourages recruitment from various
Medicaid edibility groups, ensuring that all eligible individuals have equal opportunity
to apply for open positions.
Section 5. BAC members will review applications and provide recommended
applications to the Medicaid Director.
Section 6. The Medicaid Director has the authority to make changes to the
membership and composition of the BAC, including the appointment and removal of
members, to be compliant with 42 CFR 431.12.
ARTICLE 8. QUALIFICATIONS AND RESPONSIBILITIES
Section 1. BAC members are selected based on their lived experience as Medicaid
beneficiaries (or as family members, caregivers of Medicaid beneficiaries) and
demonstrated interest in the well-being of Medicaid beneficiaries. BAC members must
be a current Medicaid beneficiary, or a family member or caregiver of a Medicaid
beneficiary.
Qualifications may include:
A. Knowledge of Medicaid services and programs.
B. Ability to represent the needs of Medicaid beneficiaries and their communities.
C. Commitment to the effective functioning of the BAC.
D. Ability to collaborate and work cooperatively with others.
E. Ability to bring community concerns and experiences to the table.
Section 2. Responsibilities of BAC members include:
A. Attending 75% of all quarterly meetings each year.
B. If the member cannot attend the meeting, they must notify the Chair and BAC
Manager.
C. Actively participating in discussions and providing input on policy issues.
D. Staying focused and on-topic for assigned agenda items. If other issues need
to be discussed, they can be:
a. Added to the next meeting agenda.
b. Discussed during the public comment portion of the meeting.
c. Put in the “parking lot” of topics to discuss.
E. Complying with Roberts Rules of meeting conduct.
a. One person talking at a time.
b. Chair or Vice-Chair to facilitate the meeting and staying within the
allotted times of the agenda.
c. Professional and respectful communication and engagement with all
BAC/MAC members and state employees.
F. Sharing personal experiences but being cautious not to share personal health
information (PHI) out of respect of all individuals.
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G. Reading the prior months minutes so that a proper vote of accepting and
making changes to the minutes can be accomplished at the next meeting.
H. Completing assigned tasks and preparing for meetings.
I. Be aware of the time allotted per agenda item. For meeting efficiency and
productivity, it is important to stay on schedule.
J. Representing the interests and concerns of Medicaid beneficiaries.
K. Assisting with recruitment and outreach efforts to other Medicaid beneficiaries.
L. Willingness to engage with Medicaid beneficiaries in the community.
Section 3. Code of Conduct. Members are expected to communicate in all forms with
respect and patience of the other person assuming positive intent.
ARTICLE 9. MEETINGS
Section 1. The BAC shall meet a minimum of four (4) times per year. Additional
meetings may be called as needed.
Section 2. The BAC Chair and BAC Manager shall collaborate on the creation of the
meeting agenda.
Section 3. Notice of meetings, including the time, date, and location, shall be sent to
BAC members at least thirty (30) working days in advance by the BAC Manager. Notice
of meetings will be posted to the department website 30 days prior to the meeting.
Section 4. A quorum (simple majority) for conducting business shall be a majority of
the BAC members. Voting shall be limited to BAC members. If BAC members are not
able to attend a meeting, they will be given the opportunity to vote by proxy. This
member must reach out to the BAC Chair and the BAC Manager in advance to
understand any voting in the upcoming meeting.
ARTICLE 10. OFFICERS
Section 1. The officers of the BAC shall include a Chair and a Vice-Chair. The Chair and
Vice-Chair shall serve for two-year, non-consecutive terms.
Section 2. The Chair shall preside over all meetings and ensure that the BAC’s
recommendations are submitted to the Medicaid Director.
Section 3. BAC members shall vote for the officers with a simple majority, every two
years.
Section 4. If BAC members feel the Chair or Vice-Chair are not serving their role
responsibly then the BAC members have the option to vote out the Chair or Vice-Chair
and vote for a replacement.
Section 5. The Chair shall create an agenda of suggested topics from the BAC with the
BAC Manager. The Chair will facilitate the BAC meetings and ensure agenda items are
covered in the allotted time.
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Section 6. The Vice-Chair shall fulfill all the responsibilities of the Chair in the event
the Chair is absent.
Section 7: If a Chair and/or Vice-Chair are unavailable or unelected, the BAC Manager
may facilitate meetings and coordinate agenda items on an interim and as-needed
basis.
ARTICLE 11. DEPARTMENT SUPPORT
Section 1. The department shall provide technical and logistical support to the BAC.
Section 2. The department shall provide the BAC with the following support:
A.Staff assistance as needed for the preparation of reports, recommendations,
and BAC governance documents, including those required in CFR 431.12. This
will be accomplished with the BAC Manager as the point of contact.
B.Financial assistance for beneficiary members to participate (e.g., honorarium,
travel reimbursement, as applicable).
ARTICLE 12. CONFLICT OF INTEREST
Section 1. BAC members must disclose any conflicts of interest and recuse
themselves from voting on matters where they have a financial interest or personal
stake. A BAC member may consider recusing themselves from a vote to recommend a
new BAC member for appointment if the BAC member directly recruited the BAC
applicant under consideration.
ARTICLE 13. REPORTS AND RECOMMENDATIONS
Section 1. Recommendations and reports from the BAC shall be submitted to the MAC
Chair and/or the Medicaid Director. Reports may include majority and minority
opinions, where applicable.
Section 2. The BAC shall contribute to the annual MAC report detailing its activities,
discussions and recommendations.
ARTICLE 14. AMENDMENTS
Section 1. Amendments to these bylaws may be proposed by any BAC member and
must be approved by a simple majority vote of the BAC members.
Section 2. Amendments shall become effective immediately following approval,
unless otherwise specified in writing.
Sasha O’Connell
Deputy Director & Medicaid Administrator,
Idaho Department of Health & Welfare
Date
11/20/25