The state eligibility systems that process ex parte renewals have not been closely scrutinized for many years. As a result, they may not be fully optimized to move all eligible individuals successfully through ex parte renewal and may not reflect the most up to date policy, guidance, and flexibilities available to states.
The value civic technologists bring to states on ex parte renewals is the ability to “look under the hood” of these state eligibility systems and identify opportunities to rapidly optimize them - maximizing the number of eligible individuals that are successfully ex parte renewed. Increasing ex parte rates reduces procedural disenrollments as well as administrative burden on both beneficiaries and state staff. Below are a few key areas where the USDS has found opportunities for optimization across several state systems. This list is not exhaustive as each state system presents unique challenges and opportunities for improvement.
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.