Research Report Administrative Renewal, Accuracy of Redetermination Outcomes, and Administrative Costs
Stan Dorn, Matthew Buettgens
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When a Medicaid beneficiary approaches the end of a 12-month enrollment period, coverage should be "administratively renewed," according to ACA a regulation, if "reliable information" shows the beneficiary remains eligible. The beneficiary is sent a notice explaining the basis for renewal and the legal duty to make needed corrections. If none are forthcoming, coverage continues. We find that using administrative renewal should lower the number of mistaken outcomes if it is used with beneficiaries known to have an 80 percent or greater likelihood of eligibility. However, administrative renewal will change most mistakes from incorrect terminations to incorrect renewals.
Research Areas Health and health care
Tags Medicaid and the Children’s Health Insurance Program  State Children's Health Insurance Program Medicare
Policy Centers Health Policy Center