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Strategic Approaches to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations


January 2023 Update

Year Developed: 2023

Resource Type: Publication.

Primary Audience: Board of Directors C-Suite (CEOs, CFOs, CIOs, COOs, CMOs, etc) Clinicians Health Center Staff

Language(s): English

Developed by: Centers for Medicare & Medicaid Services (See other resources developed by this organization).

Resource Summary: The COVID-19 pandemic and implementation of federal policies to address the resulting public health emergency (PHE) have disrupted routine Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment operations. States will have a 12-month unwinding period following tthe end of the PHE to initiate all pending post-enrollment verifications, redeterminations, and renewals. CMS is working closely with states and other stakeholders to ensure, as states resume routine operations, that renewals of eligibility occur in an orderly process that minimizes beneficiary burden and promotes continuity of coverage for eligible individuals, including those who no longer qualify for Medicaid or CHIP and therefore may transition to a different form of coverage, such as through a Marketplace.

Resource Topic: Clinical Issues, Emerging Issues, , Health Equity

Resource Subtopic: COVID-19, Population Health, , Social Determinants of Health (SDOH).

Keywords: Medicaid.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.