Medicaid applications and renewal completion timelines are under the microscope as Medicaid unwinding has stripped more than 21 million people of Medicaid coverage. Individuals have been disenrolled for multiple reasons, but problems with paperwork and timing have been the most common reasons.
On May 9, the Centers for Medicare and Medicaid Services (CMS) released an informational bulletin highlighting standards for application and renewal processing timeliness by states. The bulletin suggests states review multiple data sets and adjust policies accordingly to mitigate pinch points and facilitate smooth processing that will reduce time to enrollment or redetermination. A slide deck accompanies the bulletin further detailing how states can use existing flexibilities and reminding states of timeliness regulatory requirements included in the recently finalized rule: Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes.
Neither the rule nor the bulletins have direct effect on provider operations, though as states begin to develop and deploy processes and policies to expedited and streamline eligibility and enrollment, providers may notice a smoother participant determination process.
