Resources and Toolkits

Piece on the need for states to work quickly to build Medicaid systems that serve clients efficiently and impactfully, with information related to CMS’s Interim Final Rule

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.

Webinar session to discuss Medicaid unwinding lessons, strategies to coordinate work requirement and ex parte renewals, and methods toward designing flexible, efficient, and sustainable systems. Passcode: ^m3Q+Fuz

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)

Guide on how state agencies can develop legible and flexible metrics to assess implementation of new work requirements, outlining how to build, capture, and effectively utilize metrics to monitor impact for operational awareness and decisionmaking.

Implementation-oriented framework to support states with adapting to community engagement/work requirements. Features overview of “look back” period and four-step compliance flow including: checking for automatic hardship, screening for exemptions, checking for participation, and allowing for requestable hardship.

Outlines cases in which generative AI can be appropriately deployed by grounding use in human-centered problem statements. Highlights practical application such as data extraction, summarization, and entity resolution to reduce caseworker burden while maintaining responsible oversight.

Key questions for states to consider during procurement of new technical systems to ensure proper evaluation of product solutions and their effectiveness.

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.

Repository of resources for state administrators to support the implementation of work requirement policies through overview of implications and recommendations of smart system designs and processes.

Outlines four proactive strategies to design resilient and adaptable technical systems including feature flags, modularity, configurability, and phased approaches.