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COMBINED MEDICAID 310-1 Community Engagement and Exclusion Policy

Supersedes: New Reference: P.L. 119-21 Overview: All individuals aged 19-64 applying for or receiving ACA Medicaid Expansion (known as HELP Act) must meet community engagement requirements or have a temporary exception int the lookback period; or qualify for an exclusion. If they qualify for an exclusion, then they are not required to complete community engagement qualifying activities. Once enrolled in Medicaid, these individuals will be evaluated every (6) months to determine if they continue to meet community engagement requirements, still have an exception, or qualify for an exclusion. NOTE: American Indian/Alaska Natives are not subject to the 6-month redetermination requirement and only need to be redetermined annually or when changes are reported. Available information (i.e., Perceptive documents, electronic interfaces, meeting program requirements in SNAP/TANF program, etc.) will be used to validate qualifying community engagement activities and exclusions. Information that is not available will need to be verified by the client. Qualifying Activities: All members are required to participate at least 80 hours per month in qualifying community engagement activities or earn the equivalent of 80 hours at the federal minimum wage per month, unless excluded or eligible for an exception. A combination of activities can also meet this requirement. Note: The household income should be used when determining community engagement compliance. Activities that meet the community engagement requirement include:

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Official source

COMBINED MEDICAID 310-1 Community Engagement and Exclusion Policy

Supersedes: New Reference: P.L. 119-21 Overview: All individuals aged 19-64 applying for or receiving ACA Medicaid Expansion (known as HELP Act) must meet community engagement requirements or have a temporary exception int the lookback period; or qualify for an exclusion. If they qualify for an exclusion, then they are not required to complete community engagement qualifying activities. Once enrolled in Medicaid, these individuals will be evaluated every (6) months to determine if they continue to meet community engagement requirements, still have an exception, or qualify for an exclusion. NOTE: American Indian/Alaska Natives are not subject to the 6-month redetermination requirement and only need to be redetermined annually or when changes are reported. Available information (i.e., Perceptive documents, electronic interfaces, meeting program requirements in SNAP/TANF program, etc.) will be used to validate qualifying community engagement activities and exclusions. Information that is not available will need to be verified by the client. Qualifying Activities: All members are required to participate at least 80 hours per month in qualifying community engagement activities or earn the equivalent of 80 hours at the federal minimum wage per month, unless excluded or eligible for an exception. A combination of activities can also meet this requirement. Note: The household income should be used when determining community engagement compliance. Activities that meet the community engagement requirement include: