Medicaid Renewals Playbook

Caretaker relative challenges

Description

Family makeup, including the presence of caretaker relatives, is often a source of confusion and errors. It’s common for states to exclude families with unclear family makeups.

However, family makeup is not subject to change without notification. While family makeup can, in theory, be verified against IRS data sources, it very rarely results in a “true positive”. Regardless, states may filter out cases aggressively based on the presence of unclear caretaker relative relationships.

What this looks like

Large number of people or cases being excluded or failing ex parte renewal based on reasons like:

Potential solutions

Leverage the October 2022 guidance to reinforce that many attributes on a case are not subject to change, and thus not required to re-verify on every renewal. Once policy aligned, define a strategy to remove unecessary parent caretaker relative checks.