States begin Medicaid redetermination efforts on April 1, 2023
States will start Medicaid redetermination efforts on April 1, 2023. The Consolidated Appropriations Act, 2023 effectively terminated previous requirements that the redetermination period would begin at the end of the Public Health Emergency.
If states meet the requirements, they’ll continue to receive federal funding that will decline each quarter through December 21, 2023. Each month starting after April 1, 2023 through June 30, 2024, states must submit reports regarding redetermination efforts.
Medicaid health plans should prepare by taking the following steps:
- Review existing, and monitor for new, state communications regarding the process the state is following related to redeterminations
- Analyze impacts to plan based on the process the state enacted
- Use data analytics to identify high-risk individuals, incorporate outreach and assistance to ensure continuity of coverage for vulnerable individuals, and track enrollment to determine additional outreach efforts and/or successful enrollment, including:
- Use multiple data sources including community partners / agencies and state systems, and nutrition assistance and wage data, to ensure communication to as many Medicaid enrollees as possible
- Develop multiple options for outreach, including ensuring that member information is updated in all possible manners, including: online, in-person, phone, text, email and paid media
- Facilitate enrollee transition to the Marketplace if appropriate
- Monitor higher-than-average volumes of Medicaid and D-SNP members who fall into the deeming period while awaiting Medicaid redetermination
- Review data systems and available reports to determine needed revisions
- Develop and monitor a communications plan to catch and address issues early in the following ways:
- Use required state baseline report and monthly reports
- Monitor call center volume
- Monitor mail return rates
- Use data from community partners that assist with Medicaid enrollment process
- Monitor call center activity to ensure staff is able to manage higher call volumes
- Ensure that staff has all necessary information to assist members, including understanding the redetermination process, responding to redetermination requests, and accessing additional resources for assistance
- Outreach to state departments to identify ways the plan can help support the state’s redetermination efforts
ATTAC Consulting Group’s Medicaid operations, technology, compliance and project management experts support plans to develop and implement effective strategies and respond to state Medicaid redetermination efforts. To learn more, contact Jennifer Venditti, Senior Vice President of Business Transformation and Technology at jvenditti@attacconsulting.com
