Eligibility Redetermination for Medicaid Members

The bill authorizes the department of health care policy and financing (state department) to seek federal authorization to:

• Extend the timeline for member reenrollment in the state medical assistance program based on the financial eligibility for a member whose income is based solely on a fixed income source; and
• Verify a member's eligibility for reenrollment based on income and need at the same time.

The bill requires the state department to modify the questions asked to medical professionals when verifying a member's need for long-term services and supports and allows any licensed medical professional who has a bona fide physician-patient relationship with a member to complete the documentation necessary to verify a member's need for long-term services and supports.

The bill prohibits the state department from requiring new documentation for a member who transitions from receiving services in an institutional setting to receiving services in a home- and community-based setting and vice versa.

(Note: This summary applies to this bill as introduced.)