Overview of Final Medicaid Eligibility Regulation

Issue Briefs | Apr 12, 2012

Overview of Final Medicaid Eligibility Regulation

Manatt Health Solutions

On March 16, 2012, the Department of Health and Human Services (HHS) issued final and interim final rules codifying Medicaid eligibility and enrollment provisions of the Patient Protection and Affordable Care Act (ACA). The rules address Medicaid eligibility categories, expansion of Medicaid eligibility for non-disabled adults, modernization of eligibility verification rules, streamlining Medicaid and Children’s Health Insurance Program (CHIP) applications and renewals, and coordinating eligibility across Medicaid and CHIP. This policy brief, prepared by Manatt Health Solutions, gives a high level overview of important highlights, focusing on key areas where HHS has changed or expanded upon the proposed Medicaid rules published on August 17, 2011. It then provides a section-by-section summary of the regulations.

Expert Perspectives

March 28, 2023

State Dashboards to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement

The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states have initiated plans to publish a data dashboard to monitor progress. To date, five states—Iowa, Minnesota, Utah, Washington, and West Virginia—have publicly released some type of unwinding data (this includes states reporting unwinding data in both a dashboard and a static format, but not states with pre-existing enrollment dashboards that don’t specifically identify unwinding cohorts). SHADAC will update this expert perspective as additional dashboards go live.

March 22, 2023

Leveraging Data to Drive Results for Medicaid and Marketplace Enrollment

To maximize efforts to maintain coverage, state Medicaid agencies and Marketplaces can now leverage digital channels as part of their overall outreach and communications efforts. Rapidly evolving changes in consumer media consumption habits as well as shifts in digital channels, and the ability to leverage data sources, enables granular audience targeting and efficient use of resources. These can be incorporated into an overall integrated outreach and education campaign to maximize renewals and coverage retention.

Proposed Changes to Federal Standards for Collecting Race and Ethnicity – Summary and Considerations

Individual-level data on race and ethnicity collected within the Medicaid program and in other state agencies is greatly influenced by federal guidance. This expert perspective summarizes the proposed revisions to the federal standards for collecting race and ethnicity that are currently out for comment, and provides considerations for states interested in submitting comments.