Templates & Toolkits | Mar 17, 2023

Ensuring Compliance With Federal Renewal Requirements: State Diagnostic Assessment Tool

Patricia Boozang, Kinda Serafi, Kaylee O’Connor, and Michelle Savuto, Manatt Health

As states begin the herculean task of redetermining eligibility for 91 million enrollees in Medicaid and the Children’s Health Insurance Program, they are readying their systems, staff, and vendors that support Medicaid eligibility operations. The Consolidated Appropriations Act, 2023 provides enhanced federal funding to states to support unwinding, provided that they conduct eligibility redeterminations and renewals in compliance with federal regulatory requirements and meet certain additional conditions. Using this diagnostic assessment tool, states can take the critical step of evaluating their compliance with federal regulatory requirements for conducting redeterminations and renewals. The tool aims to help states qualify for the sustained enhanced Federal Medical Assistance Percentage, avoid corrective action imposed by CMS, promote continuity of coverage and care during unwinding, and make long-term improvements to eligibility and enrollment infrastructure.