Expert Perspectives

Apr 1, 2022 

Public Health Emergency (PHE) Unwinding Reporting Requirements: Considerations for States

New state reporting templates and guidance released by the Centers for Medicare & Medicaid Services (CMS) on March 22, 2022, build upon a State Health Official letter released on March 3. The resources specify both the data and the metrics that states will be required to submit to monitor enrollment and renewal efforts as they resume routine Medicaid and CHIP operations following the end of the COVID-19 PHE. This expert perspective summarizes the new reporting requirements and presents a set of considerations for states as they begin implementing new unwinding policies, procedures, and reporting.

Mar 11, 2022 

New CMS Guidance on Expectations for Unwinding Federal Medicaid Continuous Coverage

On March 3, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) letter, “Promoting Continuity of Coverage and Distributing Eligibility and Enrollment Workload in Medicaid, the Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) Upon Conclusion of the COVID-19 Public Health Emergency.” This expert perspective summarizes the highly anticipated guidance, which clarifies CMS expectations for state Medicaid and CHIP agencies as they prepare to process outstanding eligibility and enrollment actions when the federal Medicaid continuous coverage requirement ends.

Mar 8, 2022 

CMS Solicits Input on Medicaid and CHIP Reforms Regarding Eligibility, Enrollment, and Access to Care

On February 17, the Centers for Medicare & Medicaid Services released a request for information (RFI) regarding the federal standards that govern access to care in Medicaid and the Children’s Health Insurance Program. The RFI casts a wide net, soliciting suggestions for reform regarding access to coverage–namely, the processes for enrollment and eligibility redeterminations–as well as the standards for defining and monitoring enrollee access to care under both fee-for-service and managed care delivery systems. This expert perspective summarizes the RFI to assist states as they draft their submissions. Comments on the RFI are due by April 18.