Redline - Data Report Instrument Metrics

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Name of Instrument: Medicaid and Children’s Health Insurance Program Eligibility Processing Data Report

MONTHLY REPORT

Application Processing
    1. Total pending applications received between March 1, 2020 and the end of the month prior to the state’s unwinding period. 
        a. Pending MAGI and other disability applications
        b. Pending disability-related applications
    2. Of those applications included in Monthly Metric 1, the total number of applications completed as of the last day of the reporting period 
        a. Completed MAGI and other non-disability related applications as of the last day of the reporting period
        b. Completed disability-related applications as of the last day of the reporting period
    3. Of those applications included in Monthly Metric 1, the total number of applications that remain pending as of the last day of the reporting period
        a. Pending MAGI and other non-disability applications as of the last day of the reporting period
        b. Pending disability-related applications as of the last day of the reporting period
Renewals Initiated
    4. Total beneficiaries for whom a renewal was initiated in the reporting period
Renewals and Outcomes 
    5. Total beneficiaries due for a renewal in the reporting period
        a. Of the beneficiaries included in Metric 5, the number renewed and retained in Medicaid or CHIP (those who remain enrolled)
            i. Number of beneficiaries renewed on an ex parte basis
            ii. Number of beneficiaries renewed using a renewal form
        b. Of the beneficiaries included in Metric 5, the number determined ineligible for Medicaid or CHIP 
        c. Of the beneficiaries included in Metric 5, the number disenrolled for procedural reasons (i.e. failure to respond)
        d. Of the beneficiaries included in Metric 5, the number whose renewal was not completed 
    6. Month in which renewals due in the reporting period were initiated
    7. Number of beneficiaries due for renewal whose renewal has not yet been completed
Medicaid Fair Hearings
    8. Total number of Medicaid fair hearings pending more than 90 days at the end of the reporting period
Renewals and Outcomes (Community Engagement)
    9. Of the beneficiaries included in metric 5(a), the number renewed who are determined to be a specified excluded individual 
    10. Of the beneficiaries included in metric 5(a), the number renewed who are applicable individuals and either demonstrated community engagement or were deemed to have demonstrated community engagement by meeting a mandatory exception.
    11. Of the beneficiaries included in metric 5(a), the number renewed who are applicable individuals and were deemed to have demonstrated community engagement by meeting a short-term hardship exception. 
    12. Of the beneficiaries included in metric 5(b), the number determined ineligible due to not meeting the community engagement requirement after being provided a notice of noncompliance.
    13. Of the beneficiaries included in metric 5(c), the number disenrolled for procedural reasons after being provided a notice of noncompliance with community engagement.


Update - Renewals and Outcomes 
    5. (Update) Total beneficiaries due for a renewal in the reporting period
        a. (Update) Of the beneficiaries included in Metric 5, the number renewed and retained in Medicaid or CHIP (those who remain enrolled)
            i. (Update) Number of beneficiaries renewed on an ex parte basis
            ii. (Update) Number of beneficiaries renewed using a renewal form
        b. (Update) Of the beneficiaries included in Metric 5, the number determined ineligible for Medicaid or CHIP 
        c. (Update) Of the beneficiaries included in Metric 5, the number terminated for procedural reasons (i.e. failure to respond)
        d. (Update) Of the beneficiaries included in Metric 5, the number whose renewal was not completed 
Update - Renewals and Outcomes (Community Engagement)
    9. (Update) Of the beneficiaries included in metric 5(a), the number renewed who are determined to be a specified excluded individual 
    10. (Update) Of the beneficiaries included in metric 5(a), the number renewed who are applicable individuals and either demonstrated community engagement or were deemed to have demonstrated community engagement by meeting a mandatory exception.
    11. (Update) Of the beneficiaries included in metric 5(a), the number renewed who are applicable individuals and were deemed to have demonstrated community engagement by meeting a short-term hardship exception. 
    12. (Update) Of the beneficiaries included in metric 5(b), the number determined ineligible due to not meeting the community engagement requirement after being provided a notice of noncompliance.
    13. (Update) Of the beneficiaries included in metric 5(c), the number disenrolled for procedural reasons after being provided a notice of noncompliance with community engagement.