Assessing the Medicaid Work Requirement Vendor Landscape
This paper evaluates the technical vendor landscape as states prepare to implement Medicaid work requirements mandated by the H.R. 1 reconciliation law.
The resource outlines the extensive system changes required—including updates to client portals, eligibility logic, and notice systems—to determine whether enrollees are compliant with or exempt from the new mandates.
It details various implementation strategies, such as Consent-Based Verification (CBV), which allows gig workers and self-employed individuals to verify income by linking their personal accounts to the state’s system. Additionally, the paper provides a detailed “crosswalk” of vendor products, ranging from open-source tools like OSCER and Emmy to comprehensive platforms from companies like Gainwell, Healthy Together, and Salesforce.
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