Expert Roundtable: Improving the Effectiveness of Ex Parte Renewals

The Medicaid and CHIP Payment and Access Commission (MACPAC), a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP), is interested in understanding state policy and systems considerations regarding the use of ex parte renewals, or renewing eligibility based on available data without requiring information from Medicaid beneficiaries.

Mathematica convened a roundtable of Medicaid agency representatives and subject matter experts to explore the issues and identify possible solutions to increase the effectiveness of ex parte renewals to ease state and beneficiary administrative burden and improve the speed and accuracy of redeterminations.  Roundtable participants discussed factors that promote and inhibit successful use of ex parte, including policy and operational factors that affect states’ ability to complete ex parte renewals for different groups of Medicaid beneficiaries; information technology (IT) and systems considerations, the benefits and challenges of integrated eligibility systems and incorporating automation into ex parte renewal processes; and key considerations regarding the use of particular data sources and data source hierarchies in ex parte renewal processes.

During the September 2023 public meeting, MACPAC presented key findings from the roundtable. In addition, MACPAC published an issue brief titled Increasing the Rate of Ex Parte Renewals (September 2023) that describes the key themes and opportunities for improving the rate of ex parte renewals that emerged during the roundtable.