Model Medicaid Reinstatement Notice Language
GMMB and Manatt Health
In response to the State Medicaid Director Letter sent by the Centers for Medicare & Medicaid Services on August 30, 2023, many states are in the process of implementing mitigation strategies in order to ensure compliance with the federal renewal requirement to conduct ex parte at the individual level. Mitigation actions that states are taking include pausing procedural terminations and reinstating coverage for individuals who have been procedurally terminated due to a state’s inability to account for an individual’s eligibility status independent of others in the household. States that are reinstating Medicaid or Children’s Health Insurance Program coverage for enrollees are required to notify individuals of their reinstatement and next steps with regard to renewing their coverage.
State Health and Value Strategies has created notice language templates intended to provide states with models for communicating key information to enrollees regarding their reinstatement. The templates are intended to be a starting place that states can tailor and modify for their programs and specific mitigation plans:
- Version A is for states that are able to identify affected persons and reinstate coverage at the individual level.
- Version B is for states that need to reinstate coverage for entire households that may include affected individuals.
Tips for Writing and Disseminating Effective Notices, Based on Enrollee Feedback
- As required by federal regulations, write in plain language and ensure notices are accessible to people with limited English proficiency and people with disabilities. Ensure alignment with 42 C.F.R. § 435.918(b) if the notice is provided in an electronic format.
- Customize each notice with the state seal, Medicaid program name, agency logo and other state-specific information.
- Mail notices in clearly marked envelopes alerting the recipient that this is important information from their state Medicaid agency about their health insurance coverage; consider a colored envelope with a clearly marked “IMPORTANT, TIME-SENSITIVE INFORMATION” label.
- Start with the most important information:
- Why they are receiving the letter.
- The reason for the decision to reinstate.
- Clear instructions about next steps, including making it clear if there are none.
- Avoid vague language that could confuse people, like “you may be automatically renewed” or “most people must complete a form, but some will not.”
- Use bold, underline, italics, or other font variations where appropriate to draw attention to important information.
- Use white space and/or text call-out boxes to separate information clearly.