Medicaid Renewals Playbook

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U.S. Digital Service - Medicaid Renewals Playbook

Background

This playbook was created by the U.S. Digital Service as a rapid-response guide for civic technologists providing direct technical assistance to states during the COVID-19 Public Health Emergency (PHE) Unwinding. The content in this playbook focuses on strategies to rapidly decrease the burden of Medicaid renewals on members of the public and state staff.

This playbook is **NOT** a source of authoritative, legal, or regulatory guidance and has not been officially endorsed by the Center for Medicaid and CHIP Services (CMCS). It is advisory only, and should be adapted appropriately for each state and scenario. Ultimately, it is the responsibility of state Medicaid officials to ensure that implementation of any project is compliant with federal Medicaid statute and regulations. Refer to CMCS’s website for up to date official guidance.

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Table of contents

How to run a state engagement:

Common challenges:

Ex-parte renewal challenges Manual renewal challenges
Overview Overview
Income data hierarchy challenges Outreach and messaging
Individualized eligibility Completing a renewal
Social security number challenges Getting help and troubleshooting
Unnecessary reverifications  
Wage matching challenges  
Policy rules  
Caretaker relative challenges  
Waiver implementation challenges  
Consent requirements  
Worst case scenario challenges