From Policy to Member Action: Preparing for Medicaid Community Engagement Requirements
New Medicaid community engagement requirements are approaching, and for health plans, preparation extends well beyond understanding the policy.
Under CMS’s current framework, certain Medicaid adults will be required to meet community engagement requirements or qualify for an exemption, with states generally required to implement the new requirements by January 1, 2027. When compliance cannot be verified, the process also includes member notification and an opportunity to respond.
But understanding the regulation is only part of the challenge. Health plans also need to consider what happens when policy reaches the member: Does the communication arrive? Is it understood? Does the member know what action to take? Can they complete that action? And does the organization have the processes in place to intervene when something breaks down?
MCRA Members Avalere Health and Command Direct engaged in a panel discussion hosted by VBCExhibitHall and moderated by Desiree Vuocolo, Director of Programs and Partnerships.
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