Issue Spotting Common Policy and Operational Barriers to Ex Parte Renewals: State Assessment Tool

Health Highlights

Editor’s Note: The article below is based on the new state assessment tool, supported by the State Health and Value Strategies (SHVS) program, a grantee of the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.   

Many states are actively working to make changes to their systems to enable ex parte renewals at the individual level and implement mitigation strategies to ensure eligible Medicaid and Children’s Health Insurance Program (CHIP) enrollees retain coverage until those system changes are complete. As states take on this work, they have an opportunity to assess end-to-end renewal functionality to identify additional policy and operational changes that could increase ex parte rates and streamline renewals (and relatedly, perhaps, streamline initial eligibility determinations). A proactive approach now may help states avoid additional unforeseen systems issues and improve overall eligibility automation, streamlining and integrity.

Manatt Health’s new state assessment tool—prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program—is intended to:

  1. Help states identify common policies and/or operational processes that, if adjusted, could improve ex parte rates and renewal functionality, and
  2. Facilitate internal, cross-divisional Medicaid agency discussions across policy, operational and information technology (IT) systems.

To download a free copy of the state assessment tool—including key assessment questions, details on the ex parte issue in practice, and related regulatory and sub-regulatory guidance and resources—click here.  



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