Webinars | Jul 12, 2012

“Reasonable” Flexibility: Exploring Models to Help States Resolve Inconsistencies in Income for Medicaid, CHIP and Tax Credit Eligibility Webinar

Manatt Health Solutions – Deborah Bachrach and Kinda Serafi

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 the case of a discrepancy, CMS eligibility rules provide guidelines to help states proceed with an eligibility determination, including some flexibility for states to find data is “reasonably compatible.” These rules, which will apply to advance premium tax credit (APTC) and cost-sharing requirement (CSR), provide states with critical flexibility to operationalize eligibility decision-making by allowing states to accept small deviations in income data from different sources.

On this July 16, 2012 webinar, Deborah Bachrach and Kinda Serafi of Manatt Health Solutions, walked participants through straw models they have created to help states think through options for reasonable compatibility process flows for Medicaid, CHIP and APTC/CSR income eligibility determinations. Karen Gibson from Minnesota Department of Human Services shared preliminary thinking on planning for implementation of reasonable compatibility standards. In addition, Anne Marie Costello from CMCS and Ben Walker from CCIIO provided reactions and feedback on the models. The webinar was introduced by Chad E. Shearer, Deputy Director of the State Health Reform Assistance Network. Alice Weiss, Co-Director of Maximizing Enrollment, moderated the panel.

Click on the download button for the slide deck used during the webinar and on the link below to hear an archived version of the discussion. An appendix (referred to, but not presented during the webinar) is included at the end of the slideshow to provide illustrative examples and outline Federal requirements.

Reasonable Compatibility Straw Models Webinar

 


Expert Perspectives

January 7, 2025

Release of New E&E Guidance Related to Renewal Forms and Medicaid/Separate CHIP Transitions

Following the November release of guidance to support states’ efforts to verify eligibility and conduct renewals in compliance with federal Medicaid and CHIP requirements, the Centers for Medicare & Medicaid Services issued on December 20 two additional Center for Medicaid and CHIP Services Informational Bulletins (CIBs). This expert perspective summarizes the requirements outlined in the CIBs.

New CMS Guidance on Compliance Requirements for Provision of Medicaid/CHIP Services to Incarcerated Youth

On December 19, the Centers for Medicare and Medicaid Services released State Health Official (SHO) letter 24-006, “Provision of Medicaid and CHIP Services to Incarcerated Youth – FAQs,” which provides several clarifications for states on compliance expectations for implementing section 5121 of the Consolidated Appropriations Act of 2023. This expert perspective describes key clarifications addressed in the SHO letter.