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Medicaid Redetermination
Medicaid Redetermination is the process used to determine whether an individual remains eligible for Medicaid coverage. Most Medicaid recipients are required to renew their coverage periodically. If a participant does not complete the renewal process, they may lose Medicaid coverage, even if they remain eligible. The Medicaid Redetermination program helps participating organizations identify patients who may be approaching renewal so they can provide outreach and support before coverage is interrupted.
Why it Matters
Access to care, medications, and essential services can be interrupted when coverage ends. Early outreach and support can help patients remain enrolled and avoid gaps in care.
Participating organizations receive a monthly Medicaid Redetermination file containing patients from their panel who may be approaching a Medicaid renewal date. This information helps organizations:
Your organization maintains a patient panel with healthEconnect Alaska.
The patient panel is matched against Medicaid renewal data.
A monthly Medicaid Redetermination file is generated for your organization.
The file is delivered securely through Managed File Transfer (MFT).
The Medicaid Redetermination file may include information to support patient outreach and follow-up, such as:
Name, date of birth, address, and other identifying information.
Upcoming renewal month and other Medicaid-related information provided through the program.
Phone numbers, email addresses, and other available contact information that may assist with patient outreach.
Information such as your organization’s Medical Record Number, when available, to help match patients to internal records.
Other information that may assist in identifying, contacting, and supporting patients through the renewal process.
Identify patients who may be approaching a Medicaid renewal date and may require additional support.
Focus outreach activities on patients who may be at risk of losing coverage or experiencing a lapse in benefits.
Help patients understand the renewal process and connect them with available enrollment, eligibility, or benefits assistance resources.
Incorporate renewal information into existing care management and patient engagement workflows.
Help patients maintain coverage and avoid interruptions in appointments, medications, treatment plans, or other services.
The Medicaid Redetermination file does not include:
Organizations must have a signed participation agreement and an active patient panel on file with healthEconnect Alaska. Contact your healthEconnect Alaska account manager for assistance getting started.
After a successful patient panel upload, it may take several weeks before your organization receives its first Medicaid Redetermination file.
The Medicaid Redetermination file is delivered through the Managed File Transfer (MFT) system. Users will receive an email notification when a file is available.
Important: MFT is separate from the HIE Portal and requires a different username and password.
The file includes patients on your panel who have a Medicaid renewal due in the current month and the next three months.
Some months may contain few or no patients identified for outreach based on your organization’s patient panel and
current Medicaid renewal data.
Files remain available in MFT for 72 hours after delivery and should be downloaded promptly.
Provides a printable overview of Medicaid Redetermination, including its purpose, why it matters, frequently asked questions, and guidance for interpreting and using the files.
Provides step-by-step instructions for converting and reformatting comma-delimited (.CSV) files to ensure they can be opened, reviewed, and used correctly.
Existing Participant: If you a are an existing participant and need help accessing your Medicaid file, email your healthEconnect Alaska account manager.
The onboarding pathway provides a structured introduction to the HIE, but all resource materials are also available individually through our Resource Library. Browse guides, videos, FAQs, and training materials at any time to support your ongoing learning and day-to-day use of the HIE.