; and (B) by adding at the end the following new subparagraph: (I) Data National and State-specific Medicaid and CHIP data. ; (3) by amending paragraph (3) to read as follows: (3) Annual policy recommendations Not less frequently than once a year, MACPAC shall make recommendations regarding Federal statutes that could be enacted or policies which the Secretary or States could implement to achieve, with respect to Medicaid and CHIP, the following goals: (A) Federal and state outlays Reducing Federal and State outlays to make such programs more sustainable. (B) Financing Improving the transparency, integrity, and sustainability of financing. (C) State flexibility and efficiency Improving State flexibility, predictability, accountability, integrity, and efficiency in oversight and administration. (D) Program integrity and reduce waste, fraud, and abuse Enhancing program integrity, reducing the amount and rate of improper payments, improving internal administrative and financial controls, and enhancing efforts to curb waste, fraud, and abuse. (E) Prioritizing the most vulnerable Prioritizing benefits, care, and services for the most vulnerable, low-income Medicaid and CHIP beneficiaries, such as children and pregnant women whose family income is at or below the Federal poverty line, the elderly, and individuals with disabilities. (F) Empowering beneficiaries Improving the independence, self-direction, self-sufficiency, and empowerment of beneficiaries. ; (4) in paragraph (4)— (A) in the heading, by striking system and inserting systems ; (B) by striking MACPAC shall create and inserting the following: (A) System related to access MACPAC shall create