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We propose enhancements to the IEEE 802.14 medium access control (MAC) protocol to facilitate supporting delay sensitive asynchronous transfer mode (ATM) traffic over hybrid fiber coaxial (HFC) access networks. The proposed MAC enhancements are aimed at supporting real-time variable bit rate RT-VBR traffic such as real-time voice and video. The proposed MAC enhancements improve bandwidth utilization, while maintaining a good quality of service (QoS) for RT-VBR traffic. Our proposal facilitates the interconnection with ATM networks, and therefore, provides for an end-to-end ATM solution.