Consent is not required in order to renew an individual for Medicaid on an ex parte basis. Consent is required, however, to use IRS data in a renewal, and consent may be given from an individual for no more than five years. However, if a state does not have consent to use IRS (or the consent has “expired”), states are still required to attempt an ex parte renewal on an individual without IRS data. This may mean using other sources of income data, like quarterly wage data, state taxes, and/or private sources.
Despite this, some states will not attempt an ex parte renewal without the consent of the individual or their family members. This consent is not required, and the state must attempt an ex parte renewal.
If a state is excluding individuals from ex parte renewal for any of the following failure reasons, it may indicate a consent issue:
Check the Medicaid application of the state. Does it ask for consent? If it does, ask the state: how is this value being used? Does it prevent an ex parte renewal?
Reference federal regulations that indicate that a state must attempt an ex parte renewal regardless of whether or not an individual has given consent. Once policy aligned, determine if the state is using IRS data. If they are, find a solution where consent allows the usage of IRS data, but otherwise has no effect on the renewal. If they are not using IRS data, remove any logic related to consent completely.