Enactment of HR 1 imposes an obligation on states who have expanded Medicaid to establish work reporting requirements for ongoing eligibility under the expansion category. As states establish policies to comply with the requirements, the Center for Health Care Strategies (CHCS) released a brief providing considerations for states to establish policies that protect individuals who should be exempt from the reporting requirements because of medical frailty. The brief urges early adoption of policies and test communications, then rapid response techniques to improve both technologies and communications and screening materials. Strategies for reducing participant burden fall under five key recommendations to states:

• Implement user-friendly approaches to identifying medical frailty at initial enrollment
• Prioritize data sources based on access and impact
• Test and refine definitions of medical frailty to align with expected prevalence
• Minimize burden of manual documentation submission
• Develop parallel processes for implementation and testing

The reference material could support states more broadly than implementing medical frailty exemptions and offer thoughtful analytic approaches to policy evolution. The document is available here.