EE1
Application
CMS-required outcome
The eligibility system receives, ingests, and processes the single-streamlined applications, change of circumstances, renewal forms, and any supporting documentation requested by the state (including telephonic signatures) from individuals, for all Medicaid eligibility groups and CHIP through online via multiple browsers, mail (paper), phone, and in-person (e.g., via kiosk) applications to support eligibility determination for all Insurance Affordability Programs (Federal Health Insurance Exchange), state Medicaid or CHIP, State-Based Marketplace (SBM), Basic Health Program (BHP).
Default metrics
- Number/Percentage of applications (Medicaid only vs multi-benefit, when applicable) submitted through each modality (use Performance Indicator Data #5 'Number of Applications Received' submitted to CMS).
- Percentage of change in circumstances reported through each modality.
- Percentage of supporting documents/information submitted through each modality.
- Percentage of renewal documents submitted through each modality
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.907
- - 42 CFR 435.916
- For Guam, Puerto Rico, and the Virgin Islands:
- - 42 CFR 436.901