As states are working diligently to operationalize the unwinding of the Medicaid continuous coverage requirement, State Health and Value Strategies has been tracking the creative strategies states are implementing to minimize coverage losses. This expert perspective highlights all the hard work states are engaged in and spotlights innovative strategies other states may want to consider adopting. SHVS will continue to track and share state efforts to support coverage through the unwinding period. If your state is implementing a new effort to reach enrollees, or if you have questions about how you can implement an example included in this EP, please be in touch.
Conducting Eligibility Redeterminations at the Individual Level: State Diagnostic Assessment Tool
Kinda Serafi, Patti Boozang, and Kaylee O’Connor, Manatt Health
Early unwinding-related renewal data shows that many states have low ex parte renewal rates and high procedural termination rates. One contributing factor that the Centers for Medicare & Medicaid Services and states have identified is that some states are conducting ex parte renewal processes at the household level, rather than at the individual level, as required by federal regulations. This diagnostic assessment tool is designed to assist states in assessing whether they are conducting ex parte and other renewal processes at the individual level in accordance with federal regulatory requirements. To use this tool, states should convene a team of key policy, operations and systems owners to review and answer these questions. This will require close review and analysis of eligibility and enrollment policies, IT system business rules and other system artifacts, and operating procedures.