CHIPRA Mandated Evaluation of Express Lane Eligibility: First Year Findings. B. Understanding State Enrollment Processes


  1. Do you have a flow chart of the standard enrollment process that you could share with us? By standard enrollment process, we mean the one that most children who qualify primarily on the basis of income would complete.
    1. How long has this standard enrollment pathway been established?
    2. Have there been any major changes in this pathway in the past three years? If so, please describe these changes, when they occurred, and why they were implemented.
  2. If no flow chart is available, please talk us through the different steps that someone must complete to enroll in your state’s Medicaid and/or CHIP program through standard pathways.
    1. Please think about the different people who must review an application, enter or verify data in a computer system, or have contact with an applicant. If your state uses both electronic and paper application pathways, we are interested in developing (or obtaining) a process flow chart for both methods.
    2. Please include any steps that are completed by contracted vendors, as well as those completed by state staff.
    3. Please also consider any steps that occur in passing an application between the Medicaid and CHIP programs.
  3. Please walk us through the steps of the standard enrollment pathway(s) and indicate which steps are different for beneficiaries who enroll through the ELE pathway. In what ways do these steps differ?
    1. Has the ELE enrollment process changed since ELE was first implemented? If so, please describe the ways this process has changed.
  4. For children who primarily qualify on the basis of income, does your state offer any other facilitated enrollment pathways, aside from ELE, that would follow a different set of steps and processes?
    1. What are these alternate enrollment pathways, and how do they differ from the standard route? When were these alternate pathways implemented?
  5. If your state has also implemented ELE for renewals, please talk us through the standard renewal pathway, and any differences for an ELE renewal.

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