US HR1 Medicaid Work Requirements IG (proposed, not supported by CMS)
0.1.0 - ci-build
US HR1 Medicaid Work Requirements IG (proposed, not supported by CMS)
0.1.0 - ci-build
US HR1 Medicaid Work Requirements IG (proposed, not supported by CMS) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Phase | Activity | Timing | Key Considerations/Decision Points | Key Stakeholders |
|---|---|---|---|---|
| Phase 1: Planning and Design | Finalize state policy design | 12-16 months before implementation | • Determine scope of mandatory and exempt populations • Define verification process and frequency • Establish penalties and process for reinstatement • Decide on method of tracking and reporting compliance |
Governor's office, Medicaid agency, legislature |
| Conduct data and systems inventory | 12-16 months before implementation | • Identify data sources for employment, SNAP, TANF, etc. • Assess IT system capabilities and gaps • Determine need for new systems or modifications |
Medicaid agency, IT department, other state agencies | |
| Develop communication and outreach plan | 9-12 months before implementation | • Identify target audiences and key messages • Develop materials (website, mailers, FAQs) • Plan for stakeholder engagement and training |
Medicaid agency, communications staff, community partners | |
| Phase 2: Development and Testing | Develop and modify IT systems | 7-11 months before implementation | • Build new interfaces or modify existing systems • Develop reporting capabilities • Ensure data security and privacy protocols |
IT department, Medicaid agency, vendors |
| Test IT systems and business processes | 4-6 months before implementation | • Conduct unit, integration, and end-to-end testing • Test scenarios for exemptions, appeals, and errors • Train staff on new processes and systems |
IT department, Medicaid agency, caseworkers | |
| Phase 3: Implementation Preparation | Finalize operational procedures | 3-4 months before implementation | • Document workflows for processing, exemptions, and appeals • Establish help desk and support procedures • Finalize staffing and resource allocation |
Medicaid agency, program staff, help desk |
| Launch communication and outreach campaign | 2-3 months before implementation | • Distribute information to enrollees and stakeholders • Conduct training for partners and providers • Launch website and other communication channels |
Medicaid agency, communications staff, community partners | |
| Phase 4: Launch and Initial Operations | Begin implementation | Month 0 | • Start tracking and reporting requirements • Process initial exemptions and appeals • Monitor system performance and user feedback |
Medicaid agency, IT department, caseworkers |
| Monitor and adjust operations | 1-3 months after implementation | • Track key metrics (enrollment, exemptions, penalties) • Address operational issues and system bugs • Adjust communication and outreach as needed |
Medicaid agency, program staff, IT department | |
| Phase 5: Ongoing Operations | Continue ongoing operations and reporting | 4+ months after implementation | • Process monthly reporting and exemptions • Conduct periodic reviews and audits • Update policies and systems as needed |
Medicaid agency, program staff, legislature |