SB2021 Summary: Medicaid Eligibility Determination and Renewal Reform Act

• Establishes goals for the Department of Healthcare and Family Services to reduce procedural terminations to no more than 10% of eligible beneficiaries and provide real-time eligibility decisions for at least 75% of applicants by December 31, 2020.

• Requires submission of Medicaid and CHIP State Plan amendments to implement express lane eligibility for all beneficiaries within 90 days of enactment, streamlining the application and renewal process.

• Mandates reinstatement of coverage with no lapse for individuals who failed initial renewal but provide required verifications within 90 days, with retroactive coverage back to cancellation date.

• Creates agency-associated and enhanced user permissions allowing providers and community-based organizations to access client cases in the integrated eligibility system with proper authorization to assist with enrollment and renewal.

• Expands data matching to use federal and state electronic sources (tax records, Social Security, employment data, immigration status) and establishes "reasonable compatibility" standards allowing approval when applicant information is within 10% of federal poverty level thresholds without additional verification requests.