Operationalizing the Medical Frailty Exemption: A Step-by-Step Implementation Toolkit for States

Kinda Serafi, Jonah Frohlich and Patti Boozang

The enactment of H.R.1 introduces mandatory work reporting requirements for Medicaid expansion adults, while explicitly exempting individuals who are medically frail. This toolkit provides a structured roadmap for defining medical frailty, developing, and validating data-driven code lists, and integrating those requirements into state eligibility and enrollment workflows. The toolkit provides a step-by-step guide for how states can tackle the operationalization of medical frailty exemptions, while reducing burden on individuals and state administration and making accurate eligibility determinations.

An overview of the toolkit is also available. 

Download