Resources and Toolkits

Paper exploring how uncapped benefit calculations in payment error predictive models can help create space for more “buffer” and create inclusion or exclusion criteria for better targeted reviews and greater predictive power.

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…

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.

Resource outlining data and analytic approaches to support states through the technology implementation and integration process for Medicaid work requirements, with a focus on medical frailty exemptions.

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)