State Materials | Aug 10, 2018

Work and Community Engagement Requirements in Medicaid: State Implementation Requirements and Considerations

Patricia Boozang, Allison Orris, Mindy Lipson, and Deborah Bachrach, Manatt Health

In January 2018, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter providing guidance to states as to the circumstances under which CMS would approve 1115 demonstration waivers making work/community engagement (CE) requirements a condition of Medicaid eligibility. Since then, CMS has approved state work/CE waivers in Arkansas, Indiana, Kentucky, and New Hampshire, and additional states have submitted or are poised to submit similar waivers. Manatt Health has produced a series of charts that outline the legal, policy, financial and operational tasks and issues that states will face in adding a work/CE condition to their Medicaid program.

If you are interested in only one of the charts, they are also available as individual resources:

Chart 1: Features of Approved State Work/Community Engagement Waivers

Chart 2: CMS Guidance and Waiver Special Terms and Conditions

Chart 3: Streamlined Medicaid Application, Eligibility, and Enrollment Requirements

Chart 4: Information Technology Business Requirements Related to Work/Community Engagement Implementation

Chart 5: State Costs Associated with Implementing Work/Community Engagement Requirements

State Health and Value Strategies also recently hosted a webinar, Explaining the Stewart v. Azar Decision and Implications for States, that provided an overview of the Stewart v. Azar decision and its potential implications for states with approved, pending or planned Medicaid waivers that include work/community engagement requirements.


Expert Perspectives

Collaborating to Connect Consumers to Coverage

This year has presented many unique and unexpected challenges, but as open enrollment approaches states are making concerted efforts to connect residents with public and private health coverage options and are anticipating more churn between programs than ever before amid the COVID-19 public health crisis. Millions have filed for unemployment since the pandemic began, many losing their employer-sponsored health coverage or experiencing income loss in the process. As consumers navigate ongoing changes in their income or health coverage, it is more important than ever to clearly communicate with consumers what health coverage options are available for the remainder of 2020 and heading into 2021. This expert perspective lays out key takeaways on messaging to consumers to enroll in coverage this OEP and highlights examples from two states.

October 19, 2020

Ensuring Access to the COVID-19 Vaccine for Adult Medicaid Enrollees: A Roadmap for States

This expert perspective provides a roadmap for states to assess their vaccine coverage policies in Medicaid and, if necessary, to close any coverage gaps that might otherwise inhibit vaccine uptake during a crucial period of mass immunization. The concluding section discusses the possibility of congressional action that may alter the federal landscape for Medicaid vaccine coverage.