Resources and Toolkits

Guide and tool for states to track Medicaid administrative costs of implementing H.R.1

Analysis examining how states are likely to implement H.R. 1’s Medicaid provisions, including work requirements and other policies that can put eligible people at risk of losing coverage due to administrative barriers.The resource outlines key implementation timelines under both early and standard implementation scenarios, highlighting the first and last enrollee cohorts affected, major state policy…

This toolkit is intended to support states in understanding and implementing H.R.1’s new copay requirements for certain Medicaid expansion enrollees that meet specific income requirements. Included is a proposed operational approach to ensure compliance with federal requirements and reduce states’ administrative burden and potential barriers for members.

Resource is intended to support states as they explain work reporting requirements in H.R. 1. It is designed to help states create clear, linguistically and culturally appropriate materials for people enrolled in or eligible for Medicaid. Each term includes a plain-language definition, alternative ways to explain it, and guidance on why clarity matters.

States can simplify and streamline determinations for individuals and agenciesand, reduce administrative burden, and minimize unnecessary coverage loss by leveraging the overlap in compliance activities and exemption reasons for individuals applying for or enrolled in both programs. Strategies on aligning exemptions, sharing data, and integrating verification processes highlighted through process flows and crosswalks.

CMS is offering states an open source, consent-based verification tool to streamline implementation of the Medicaid work requirement. This supports income verification for non-traditional workers, allows applicant review, and enables flexible system integration. Emmy API will also provide a single point of access for relevant data sources.

Issue brief outlining the strategic case for investment in monitoring, provides a phased action timeline for states to implement monitoring activities, and details potential priority monitoring domains.

Webinar communicating new Medicaid work reporting requirements under H.R.1, highlighting how strong outreach strategies can help states protect coverage and support implementation. Experts from GMMB and Health Equity Solutions shared a communications framework and emphasized engaging enrollees in planning and message development.

Designed for state Medicaid and health and human services communications staff—particularly those responsible for planning and executing outreach related to new work reporting requirements. States can use it to inform the creation of communications efforts or to cross-reference existing plans, ensuring key tactics are considered, gaps are identified, and strategies are aligned around maintaining coverage…

A CMS-developed suite of open-source tools that streamlines income and community engagement reporting for Medicaid applicants and enrollees

A sequenced, implementation-ready approach for operationalizing the medical-frailty exemption.

Describes approaches states will take toward implementation, highlights considerations for evaluating vendors, and provides detailed descriptions of vendor products across categories (based on product demos and conversations with vendors)

Centralized hub for OBBBA Medicaid-related information for state implementation support. Features topics outlining communications and outreach, marketplace provisions, work requirements reporting, non-citizen eligibility changes, reporting and evaluation, rural health transformation, and state-specific impact estimates.

Toolkit outlining federal statutory definitions for qualifying activities and mandatory exemptions, describing criteria for ex parte verifications, and assessing need for additional application questions.

Toolkit outlining key implementation milestones for states to launch work reporting requirements including creation of governance structure, shaping policy and operational design (e.g. defining state choice for “look back period”, qualifying compliance activities, etc.), preparing staff and systems readiness, partner engagement, enrollee education, and monitoring and oversight.

Implementation details on Medicaid work requirements outlining affected populations, exemptions, compliance pathways, information on state policy choices, and implementation timeline.

Key questions for states to consider in human-centered vendor acquisition, focused on collaborative co-design and continuous feedback from enrollees and caseworkers during systems testing and development, proactive bias mitigation, accessibility, and strong data protection and interoperability standards.

Toolkit for states to define “medical frailty” work reporting requirement exemption through mechanism of alignment while aligning with CMS standards.

Outlines strategies to reduce coverage losses including minimizing administrative and applicant burden, streamlining verification processes, creating accessible and user-friendly forms and portals, and strengthening communication and outreach efforts.