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redetermination
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Journal Article
J Health Polit Policy Law (2016) 41 (2): 225–237.
Published: 01 April 2016
...Michael Koetting Abstract States are required to conduct annual Medicaid redeterminations. How these redeterminations are undertaken is crucial to determining the nature of Medicaid coverage. There can be wide variations in the proportion of clients disenrolled, with potentially large numbers...
Journal Article
J Health Polit Policy Law (2016) 41 (2): 155–156.
Published: 01 April 2016
... section contains two articles. In “Medicaid Contradictions: Adding, Subtracting, and Redeterminations in Illinois,” Michael Koetting provides a useful on-the-ground report on how the redetermination process is having a significant impact on Medicaid enrollments and uses Illinois as a case study...
Journal Article
J Health Polit Policy Law (2021) 46 (4): 611–625.
Published: 01 August 2021
... redetermination obligations, terminate coverage for those no longer eligible, and comply with Medicaid's due process notice and hearing guarantees. This will take time, additional resources, and a relaxation of federal policies aimed at ensuring timely state redetermination procedures. To ensure that states...
Journal Article
J Health Polit Policy Law (2024) 49 (6): 1051–1074.
Published: 01 December 2024
... they redetermine eligibility after the initial application, and procedural details can significantly affect enrollment outcomes (Koetting 2016 ). For adults, some states conduct one check between annual renewals, while others may conduct checks on a quarterly basis or more frequently (Artiga and Pham 2019...
FIGURES
Includes: Supplementary data
Journal Article
J Health Polit Policy Law (2004) 29 (3): 451–490.
Published: 01 June 2004
...). As we discuss below, these
changes have included simplifying forms and documentation require-
ments, substituting mail-in and telephone applications for face-to-face
interviews, reducing or eliminating monthly eligibility redeterminations,
and creating presumptive eligibility procedures that allow...
Journal Article
J Health Polit Policy Law (1990) 15 (2): 387–411.
Published: 01 April 1990
...-
termination, applying more stringent standards and procedures than had previously
been employed. A year before, Congress had authorized triennial redeterminations,
but the stricter standards and procedures were the SSA’s invention. Nearly half
of the cases reviewed led to determinations...
Journal Article
Addressing Medicaid/Marketplace Churn Through Multimarket Plans: Assessing the Current State of Play
J Health Polit Policy Law (2015) 40 (1): 233–242.
Published: 01 February 2015
... determination and redetermination system — lies at the heart of the Medicaid amendments as well as the design of the health insurance exchange. States' deep concerns over the workability of this model, coupled with fears that they would lose control over Medicaid enrollment, led to its early demise however...
Journal Article
J Health Polit Policy Law (1978) 3 (1): 54–70.
Published: 01 February 1978
... demonstrates.
B. Changes over time in state programs. Public programs change in
response to a variety of factors: redeterminations of the need for
programs, improvements produced by the original program, failure of the
original program to achieve the desired results, fiscal pressures...
Journal Article
J Health Polit Policy Law (2001) 26 (6): 1223–1260.
Published: 01 December 2001
... . Dear State Medicaid Director. Letter on Improper Terminations, Federal Requirements for Redetermining Medicaid Eligibility, and Operation of Computerized Eligibility Systems, April 7. Available on-line at http://www.hcfa.gov/medicaid/smd40700.htm . Winterbottom, Colin, David W. Liska, and Karen M...
Journal Article
J Health Polit Policy Law (1991) 16 (3): 553–572.
Published: 01 June 1991
...-
ness risk, the fair-rental approach seems clearly superior.
Rate-setting frequency. Another key rate-setting issue is the question of
whether to redetermine the rental rate for a facility annually or to maintain
the rate as a constant. Establishing the rate once, at the beginning of a fa...
Journal Article
J Health Polit Policy Law (2022) 47 (3): 293–318.
Published: 01 June 2022
... of nonenrollment because renewals and redeterminations can sometimes cause temporary coverage disruptions, and we wanted to ensure we were identifying those who lost eligibility. We used two data sources for this study: Wisconsin's all-payer claims database (published by the Wisconsin Health Information...
FIGURES
Includes: Supplementary data
Journal Article
J Health Polit Policy Law 11567676.
Published: 27 September 2024
... in March 2023, up from 71 million before the pandemic (CMS 2023). In April 2023, the continuous coverage requirement ended, and the post-pandemic unwinding began, as states reinstated eligibility redeterminations. Millions lost coverage, some because they were no longer eligible, others, including...
Journal Article
J Health Polit Policy Law (1984) 9 (2): 291–313.
Published: 01 April 1984
... that interpretation, the Court still left open
the possibility that other rights violations existed on constitutional or statutory
grounds.) Also, the Court returned the Boston State Hospital case to the First
Circuit Court of Appeals for a redetermination in light of a Massachusetts Su-
preme Court ruling...
Journal Article
J Health Polit Policy Law (1988) 13 (3): 525–546.
Published: 01 June 1988
...-of-care
criteria at program entry and at periodic redeterminations thereafter (usually an-
nually). States may, at their own discretion, apply more restrictive level-of-care
criteria to enhance the cost-effectiveness of their waiver programs.
States were asked whether waiver recipients were only...
Journal Article
J Health Polit Policy Law 11567692.
Published: 27 September 2024
... continuous eligibility to eliminate the stigmatizing process of month-to-month redeterminations and to increase continuity of care. Finally, almost all states changed the name of their Medicaid program, especially for programs associated with SCHIP, to user-friendly names, such as Denali KidCare in Alaska...
Journal Article
J Health Polit Policy Law (1997) 22 (3): 839–878.
Published: 01 June 1997
..., many recipients are on AFDC for relatively short
periods of time and face periodic eligibility redeterminations which cre-
ate added instability in enrollment. The resulting turnover, as well as the
stigma of being identified as a welfare recipient, impedes the formation
of an interest group...
