State Medicaid Agencies’ Efforts to Address Multi-State Enrollment

Support for this expert perspective was provided by the State Health and Value Strategies program, a grantee of the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

June 13, 2025

When a Medicaid enrollee moves out of state, they are required to report their change of residence to the Medicaid agency. However, many fail to do so, whether because they are unaware of this requirement or unsure of how to update their information, or their higher priority is enrolling in Medicaid in their new state of residence. This can result in Medicaid enrollment in more than one state (duplicate enrollment), which has been a persistent challenge for state Medicaid agencies. One result of this challenge is that if one or both states in which an individual is “duplicate enrolled” operate their Medicaid program through a Medicaid managed care delivery system, monthly capitation payments could be issued to a state health plan even though the person no longer resides in or seeks care in that state. This is an administrative problem that leads to unintentional waste of state and federal funds.

To mitigate duplicate Medicaid enrollment and payment, Medicaid statute and regulation require states to conduct data matching through the Public Assistance Reporting Information System (PARIS) which is administered by the U.S. Department of Health and Human Services Administration for Children and Families and is the only data resource available to states for this purpose. As part of the mandatory Medicaid Modified Adjusted Gross Income Verification Plan, all states must inform the Centers for Medicare & Medicaid Services, in detail, of how they use PARIS data to identify and avoid duplication of coverage.

A new expert perspective by Manatt Health Senior Managing Director Partner , and Partner and Senior Advisor lays out the current challenges with using PARIS data matching and provides recommendations on how to improve identification of concurrent Medicaid enrollment.

To read the full expert perspective, click .