Reasonable Compatibility Straw Models: Federal Requirements and State Options for Constructing a State’s Financial Reasonable Compatibility Standard
Manatt Health Solutions has created Reasonable Compatibility Straw Models to help state implementers better understand how to operationalize the Affordable Care Act’s (ACA) eligibility rules in their state systems.
The Patient Protection and Affordable Care Act (ACA) has prompted the Centers for Medicare and Medicaid Services (CMS) to promulgate Medicaid and CHIP eligibility rules designed to simplify and collapse Medicaid eligibility categories in preparation for the changes in Medicaid that will become effective under the ACA in 2014.
The State Health Reform Assistance Network hosted its Annual Meeting in Portland, Oregon to bring together state officials and State Network technical assistance providers for a three day intensive meeting from July 11-13, 2012. The Annual Meeting provided an opportunity for state officials to hear from Oregon Governor John Kitzhaber, Len Nichols, and Jeanene Smith during plenary sessions.
The 2014 Medicaid Eligibility Transition Toolkit is designed to assist states in systematically identifying issues and decisions they will face as they convert to 2014. The toolkit was originally provided to two states by the National Academy for State Health Policy (NASHP) as part of the State Health Reform Assistance Network that is funded by the Robert Wood Johnson Foundation. NASHP has updated the toolkit to be applicable to any state and to reflect the final Medicaid eligibility rules.
“Reasonable” Flexibility: Exploring Models to Help States Resolve Inconsistencies in Income for Medicaid, CHIP and Tax Credit Eligibility Webinar
This webinar offered detailed analysis of the standards under which states can find “reasonable compatibility” of income information provided by applicants for Medicaid, CHIP and the exchanges that is not precisely equivalent. Income data is typically neither static nor centralized, and states must be prepared to resolve discrepancies when income data is submitted by applicants or retrieved from state, federal, or other independent sources.
In 2014, millions of Americans will be eligible to enroll in Medicaid for the first time. To help states develop effective strategies and messages to promote enrollment when the program expands, GMMB in coordination with Lake Research Partners conducted in-depth qualitative and quantitative research through the State Network with people who will be newly eligible in 2014 in Alabama, Maryland, and Michigan.
he Affordable Care Act and the final Medicaid and Exchange regulations issued in March 2012 contemplate: real-time eligibility determinations; coordinated information technology eligibility systems across Insurance Affordability Programs; and, a simplified enrollment pathway for applicants that relies on electronic database verification coupled with self-attestation.
This State Network sponsored Small Group Convening was held in Minneapolis, Minnesota from April 30- May 1, 2012. The State Health Access Data Assistance Center (SHADAC) and other technical experts led sessions to aid state officials in developing an effective evaluation framework in the context of the Affordable Care Act.
This joint meeting, hosted by the State Network and Medicaid Leadership Institute, was held in Boston, MA on April 23-24, 2012. The Center for Health Care Strategies (CHCS) led sessions that ranged from continuity of care during coverage transition to methods for integrated care and reimbursement.
Under health reform, Medicaid will expand in 2014 to cover an additional 16 to 20 million beneficiaries. This population will include a significant percentage of childless adults with urgent and complex health care needs, who are likely to shift between subsidy programs over time.