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Crosswalk - Data Report
ICR 202610-0938-013 · OMB 0938-1148 · Object 174254700.
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| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Crosswalk - Data Report |
| Author | Tess Hines |
| Last Modified By | Calc |
| File Modified | 2026-05-01 |
| File Created | 2026-10-28 |
| Conversion State | complete |
Extracted Text
Eligibiltiy Processing Data Report Changes Eligibility Processing Data Report Eligibiltiy Processing Data Form Form In Submission Portal Section Eligibiltiy Processing Data Report Metric - 2024 Iteration Eligibiltiy Processing Data Report Metric - 2026 Iteration Entire Report N/A For any questions, please contact: [email protected] For any questions, please contact: [email protected] Entire Report N/A Entire Report N/A 2) As of August 28, 2024, the "Updated Renewals and Outcomes” section is 2) The "Updated Renewals and Outcomes” available for states to report the outcomes section is available for states to report the of previously pending renewals. This outcomes of previously pending renewals. section will be available in each monthly This section will be available in each report beginning three months after the end monthly report beginning three months of the original reporting month. Please after the end of the original reporting refer to the specifications for more month. Please refer to the specifications for information. more information. N/A Monthly Report Application Processing Metric 1: Total pending applications received between March 1, 2020 and the end of the month prior to the state's unwinding period (1a+1b) 3.) The “Renewals and Outcomes (Community Engagement)” section is available for states to report additional detail about the outcomes of renewals for beneficiaries enrolled on a basis subject to community engagement. Please refer to the specifications for more information. Metric 1: Total pending applications received between March 1, 2020 and the end of the month prior to the state's unwinding period (1a+1b) Monthly Report Application Processing Metric 1a: Total MAGI and other nondisaiblity applications (2a+3a) Metric 1a: Total MAGI and other nondisaiblity applications (2a+3a) Eligibiltiy Processing Data Report Changes Eligibility Processing Data Report Eligibiltiy Processing Data Form Form In Submission Portal Section Eligibiltiy Processing Data Report Metric - 2024 Iteration Eligibiltiy Processing Data Report Metric - 2026 Iteration Monthly Report Application Processing Metric 1b. Total disability-related applications (2b+3a) Metric 1b. Total disability-related applications (2b+3a) Monthly Report Application Processing Metric 2: Of those applications included in Metric 2: Of those applications included in Monthly Metric 1, the total number of Monthly Metric 1, the total number of applications completed as of the last day of applications completed as of the last day of the reporting period (2a+2b) the reporting period (2a+2b) Monthly Report Application Processing Metric 2a: Completed MAGI and other Metric 2a: Completed MAGI and other non-disability related applications as of the non-disability related applications as of the last day of the reporting period last day of the reporting period Monthly Report Application Processing Metric 2b: Completed disability-related applications as of the last day of the reporting period Monthly Report Application Processing Metric 3: Of those applications included in Metric 3: Of those applications included in Monthly Metric 1, the total number of Monthly Metric 1, the total number of applications that remain pending as of the applications that remain pending as of the last day of the reporting period (3a+3b) last day of the reporting period (3a+3b) Monthly Report Application Processing Metric 3a: Pending MAGI and other non- Metric 3a: Pending MAGI and other nondisability applications as of the last day of disability applications as of the last day of the reporting period the reporting period Monthly Report Application Processing Metric 3b: Pending disability-related applications as of the last day of the reporting period Metric 3b: Pending disability-related applications as of the last day of the reporting period Monthly Report Renewals Initiated Metric 4: Total beneficiaries for whom a renewal was initiated in the reporting period Metric 4: Total beneficiaries for whom a renewal was initiated in the reporting period Metric 2b: Completed disability-related applications as of the last day of the reporting period Eligibiltiy Processing Data Report Changes Eligibility Processing Data Report Eligibiltiy Processing Data Form Form In Submission Portal Section Eligibiltiy Processing Data Report Metric - 2024 Iteration Eligibiltiy Processing Data Report Metric - 2026 Iteration Monthly Report Renewals and Outcomes Metric 5: Total beneficiaries due for renewal in the reporting period (5a+5b+5c+5d) Metric 5: Total beneficiaries due for renewal in the reporting period (5a+5b+5c+5d) Monthly Report Renewals and Outcomes Metric 5a: Of the beneficiaries included in Metric 5a: Of the beneficiaries included in Metric 5, the number renewed and retained Metric 5, the number renewed and retained in Medicaid or CHIP (those who remained in Medicaid or CHIP (those who remained enrolled) [5a(1) + 5a(2)] enrolled) [5a(1) + 5a(2)] Monthly Report Renewals and Outcomes Metric 5a(1): Number of beneficiaries renewed on an ex parte basis Metric 5a(1): Number of beneficiaries renewed on an ex parte basis Monthly Report Renewals and Outcomes Metric 5a(2): Number of beneficiaries renewed using a pre-populated renewal form Metric 5a(2): Number of beneficiaries renewed using a renewal form Monthly Report Renewals and Outcomes Monthly Report Renewals and Outcomes Metric 5b: Of the beneficiaries included in Metric 5b: Of the beneficiaries included in Metric 5, the number determined ineligible Metric 5, the number determined ineligible for Medicaid or CHIP (and transferred to for Medicaid or CHIP Marketplace) Metric 5c: Of the beneficiaries included in Metric 5c: Of the beneficiaries included in Metric 5, the number terminated for Metric 5, the number disenrolled for procedural reasons (i.e. failure to respond) procedural reasons (i.e. failure to respond) Monthly Report Renewals and Outcomes Monthly Report Renewals and Outcomes Metric 5d: Of the beneficiaries included in Metric 5d: Of the beneficiaries included in Metric 5, the number whose renewal was Metric 5, the number whose renewal was not completed not completed Metric 6: Month in which renewals due in Metric 6: Month in which renewals due in the reporting month were initiated the reporting month were initiated Eligibiltiy Processing Data Report Changes Eligibility Processing Data Report Eligibiltiy Processing Data Form Form In Submission Portal Section Eligibiltiy Processing Data Report Metric - 2024 Iteration Monthly Report Renewals and Outcomes Monthly Report Medicaid Fair Hearings Monthly Report Renewals and Outcomes (Community Engagement) Renewals and Outcomes (Community Engagement) Metric 7:Number of beneficiaries due for a Metric 7:Number of beneficiaries due for a renewal since the beginning of the state's renewal whose renewal has not yet been unwinding period whose renewal has not completed yet been completed Metric 8: Total number of Medicaid fair Metric 8: Total number of Medicaid fair hearings pending more than 90 days at the hearings pending more than 90 days at the end of the reporting period end of the reporting period Renewals and Outcomes (Community N/A Engagement) Metric 9: Of the beneficiaries included in N/A metric 5(a), the number renewed who are determined to be a specified excluded individual Monthly Report Monthly Report Renewals and Outcomes (Community Engagement) N/A Monthly Report Renewals and Outcomes (Community Engagement) N/A Monthly Report Renewals and Outcomes (Community Engagement) N/A Eligibiltiy Processing Data Report Metric - 2026 Iteration Metric 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 Metric 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 Metric 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 Eligibiltiy Processing Data Report Changes Eligibility Processing Data Report Eligibiltiy Processing Data Form Form In Submission Portal Section Eligibiltiy Processing Data Report Metric - 2024 Iteration Eligibiltiy Processing Data Report Metric - 2026 Iteration Metric 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 Monthly Report Renewals and Outcomes (Community Engagement) N/A Monthly Report Updated Renewals and Outcomes Metrics 5, 5a, 5a(1), 5a(2), 5b, 5c, 5d fields Metrics 5, 5a, 5a(1), 5a(2), 5b, 5c, 5d, 9, 10, 11, 12, 13 fields Report Changes Type of Change from 2024 to 2026 Iteration Description of Change Revision (no burden implication) Updated the email where states may No burden implications submit technical assistance questions on data reporting to a CMS owned mailbox. There is no difference in how states may submit questions and CMS responds to questions submitted through the updated mailbox. Revision (no burden implication) Removed date to describe when the "Updated Renewals and Outcomes" section of the portal form became available Revision (no burden implication) Adding note in the portal that a new No burden implications "Renewal and Outcomes (Community Engagement)" section was added to account for the new data collection described in this iteration. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. Burden Implications No burden implications Report Changes Type of Change from 2024 to 2026 Iteration Description of Change None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. States only report on the No burden implications application process metrics until they reach 0 pending applications. None No change. Existing data collection. No burden implications Burden Implications Report Changes Type of Change from 2024 to 2026 Iteration Description of Change None No change. Existing data collection. No burden implications None No change. Existing data collection. No burden implications None No change. Existing data collection. No burden implications None No change. Existing data collection. No burden implications None No change. Existing data collection. No burden implications Revision (no burden implication) Replaced the word "terminated" with No burden implications "disenrolled" to reflect current terminology. No change to the existing data collection. None No change. Existing data collection. No burden implications None No change. Existing data collection. No burden implications Burden Implications Report Changes Type of Change from 2024 to 2026 Iteration Description of Change None No change. Existing data collection. No burden implications None No change. Existing data collection. No burden implications Revision (no burden implication) Portal form section header for new No burden implications data collection New community engagemnet data Time and cost for monthly reporting metric to capture the total count of beneficiaries renewed who are determined to be a specified excluded individual New community engagemnet data Time and cost for monthly reporting metric to capture the total count of beneficiaries renewed who are applicable individuals and demonstrated or were deemed to have demonstrated community engagement New community engagemnet data Time and cost for monthly reporting metric to capture the total count of beneficiaries renewed who were deemed to have demonstrated community engagement through one of the short-term hardships (if option to provide short-term hardships are elected by the state). States that do not select to offer short-term hardships in the state plan may select "not applicable" in the system. New data collection New data collection New data collection New data collection New community engagemnet data metric to capture the total count of beneficiaries determined ineligible due to not meeting the communitiy engagement requirement Burden Implications Time and cost for monthly reporting Report Changes Type of Change from 2024 to 2026 Iteration Description of Change New data collection New community engagemnet data Time and cost for monthly reporting metric to capture the total count of beneficiaries disenrolled for procedural reasons related to community engagement (i.e., not returning forms or paperwork to demonstrate community engagement). Modifcation to the "Updated Time and cost for one-time update to each Renewals and Outcomes" section of previously submitted monthly report for the the monthly form in the submission new data collection added in this iteration portal to duplicate fields for new (new Metrics 9-13) metrics added in this iteration (Metrics 9-13). This allows states to provide a one-time update to previously reported data. This section of the report duplicates the metrics listed above so states do not need to overwrite previously reproted data when they make updates. New data collection Burden Implications