In This Week’s Update:

• CMS Guidance on Conducting Eligibility Redeterminations
• SHVS Resources: Improving Ex Parte Processes

 

CMS Guidance on Conducting Eligibility Redeterminations

Last week, CMS issued a State Medicaid Director Letter (SMDL) instructing states to assess whether they are in compliance with federal Medicaid regulations that require all renewal processes be conducted at the individual level. CMS recently determined that some states may be conducting ex parte renewal processes at the household level, rather than at the individual level. State Health and Value Strategies published an expert perspective summarizing the SMDL and additional considerations for states as they evaluate whether, and the extent to which, their renewal policy, processes, and systems are out of compliance with federal requirements to redetermine eligibility on an individual enrollee basis.

 

SHVS Resources: Improving Ex Parte Processes

The full length State Health Update will officially return after Labor Day, but in light of the recent CMS guidance, here are SHVS resources related to improving ex parte processes: 

• Conducting Eligibility Redeterminations at the Individual Level: State Diagnostic Assessment Tool – This diagnostic assessment tool is designed to assist states in assessing whether they are conducting ex parte and other renewal processes at the individual level in accordance with federal regulatory requirements.
• Ensuring Compliance With Federal Renewal Requirements: State Diagnostic Assessment Tool – Using this diagnostic assessment tool, states can take the critical step of evaluating their compliance with federal regulatory requirements for conducting redeterminations and renewals.
• Improving Ex Parte Renewal Rates: State Diagnostic Assessment Tool – This toolkit contains a table that can be used by a state to examine current ex parte processes and identify and deploy additional strategies that could increase their ex parte rates.
• Improving Ex Parte Renewal Rates to Support Unwinding: Questions and Answers – This Q&A is intended to serve as a resource for states looking to improve their current ex parte processes to support their efforts during unwinding and well beyond.