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During the COVID-19 public health emergency (PHE), Medicaid was required to maintain enrollment of nearly all Medicaid enrollees – even if the patient was no longer eligible. Medicaid renewals will not be automatic this year. Starting in April 2023, Maryland began making Medicaid eligibility reviews, or “redeterminations” again. Not everyone will be up for renewal at the same time. These renewals will take place over 12 months. Redetermination is a process where Medicaid collects up to date information from patients to determine if they are eligible for Medicaid insurance. This is the first time some Medicaid enrollees will have completed redetermination. CRISP is determined to spread awareness of the upcoming changes, as well as assist our participants reach all their Medicaid patients.
In partnership with Maryland Medicaid, CRISP can provide interested healthcare delivery sites with a monthly list of their patients who are up for redetermination in the next 90 days. This data can assist healthcare teams in patient education and awareness to support patients in their redetermination process. This data can help prevent patients from showing up to appointments unexpectedly without coverage. Fewer patients will need to reschedule their appointments and delay necessary care. Care delivery sites can also avoid inefficiencies related to patients being unexpectedly uninsured. The file/list of patients will include information that may aid in patient outreach. More information about the file creation, contents, and delivery method is available in the linked documents below.
All CRISP participants with an active Encounter Notification System (ENS) panel on file that contains currently enrolled Medicaid patients can receive a monthly redetermination file. A CRISP participant is a HIPAA covered entity with a signed participation agreement with CRISP. An eligible organization can request access to receive a Medicaid Redetermination file from CRISP for their organization by contacting their outreach representative.