The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. Reducing the number of people who lose coverage for procedural reasons even though they remain eligible can also help to reduce the number of people who become uninsured. But there are very real concerns that many people who are actually still eligible for Medicaid might lose their coverage due to a lack of understanding of the process, onerous paper-based eligibility redetermination systems, unstable housing/communication situations, etc. As a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. To reduce the administrative burden on states, CMS announced the availability of temporary waivers through Section 1902(e)(14)(A) of the Social Security Act. Its only a pay-for because youd be removing people from Medicaid, said Brian Blase, the president of the conservative Paragon Health institute and a former senior Senate Republican aide. The latest extension will expire on April 16, 2022. By law, public health emergencies are declared in 90-day increments. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 528 0 obj <>/Filter/FlateDecode/ID[<3C6513E815B48242A21C94DD62711375>]/Index[506 36]/Info 505 0 R/Length 108/Prev 319214/Root 507 0 R/Size 542/Type/XRef/W[1 3 1]>>stream The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. Theres always a risk of scams and abuses should that happen, Rollins cautioned, arguing that the calling and texting ban should only be lifted for the period of the Medicaid redeterminations. Meghana Ammula About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. The Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency. This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following. There are also monthly reporting rules included in the law, designed to ensure transparency and accountability throughout the unwinding of the FFCRAs continuous coverage requirements. States that fail to comply with these reporting requirements face a reduction in federal medical assistance percentage (FMAP) of up to one percentage point for the quarter in which the requirements are not met. Medicaid is a prime example: As of late 2022, enrollment in Medicaid/CHIP stood at nearly 91 million people, with more than 19 million new enrollees since early 2020. 01:02. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. expected to be extended again in January 2023, Medicaid eligibility redetermination process, very difficult to plan for the resumption of Medicaid eligibility redeterminations, Childrens Health Insurance Program (CHIP), were not required to suspend CHIP disenrollments during the pandemic, Texas is an example of a state taking this approach, Virginia is an example of a state taking this approach, Tennessee is an example of a state taking this approach, Georgia is an example of a state taking this approach, continued to send out these renewal notifications and information requests, Medicaid and CHIP eligibility for children extend to significantly higher income ranges, Medicaid eligibility rules are much different (and include asset tests) for people 65 and older, elect to have their Medicare coverage retroactive to the day after their Medicaid ended, But it will start to apply again as of June 10, 2023, health insurance marketplace in your state, pleasantly surprised to see how affordable the coverage will be, read this article about strategies for avoiding the coverage gap, the income levels that will make you eligible, American Rescue Plans subsidy enhancements. Regardless of timing, the lifting of the continuous enrollment requirement will have a substantial impact on states and Medicaid enrollees, particularly in states that have been unable to renew coverage automatically for a significant portion of enrollees. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. States can also consider sharing information on consumers losing Medicaid who may be eligible for Marketplace coverage with Marketplace assister programs; however, in a recent survey, few assister programs (29%) expected states to provide this information although nearly half were unsure of their states plans. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. CMS is releasing the 2022-2023 Medicaid Managed Care Rate Development Guide for states to use when setting rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2022 and June 30, 2023. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . As of March 2022, the Medicaid expansion had extended coverage to 8 million low-income adults who would not otherwise have been eligible for Medicaid without it. Question Is there an association between prenatal care coverage in emergency Medicaid (a program of restricted Medicaid services for recent immigrants with low income who are pregnant) and the use of antidiabetic agents by pregnant Latina individuals with gestational diabetes?. Churn can result in access barriers as well as additional administrative costs. However, waivers that allowed advanced practice registered nurses (APRNs) to practice at the top of their license will expire on October 9 absent further Congressional action. Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. Any information we provide is limited to those plans we do offer in your area. Medicaid eligibility redeterminations will resume in 2023. 1. Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. Further, states must also comply with federal rules about conducting renewals. But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. Update regarding intent to end the national emergency and public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023 Update: On Thursday, December 29, 2022, President Biden signed into law H.R. However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online. Based on illustrative scenariosa 5% decline in total enrollment and a 13% decline in enrollmentKFF estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage during the 12-month unwinding period (Figure 2). CMS guidance also outlines specific steps states can take, including ensuring accessibility of forms and notices for people with LEP and people with disabilities and reviewing communications strategies to ensure accessibility of information. Eligible individuals are at risk for losing coverage if they do not receive or understand notices or forms requesting additional information to verify eligibility or do not respond to requests within required timeframes. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. The overriding thing state Medicaid agencies want is certainty about what is coming, Jack Rollins, the director of federal policy for the National Association of Medicaid Directors, told POLITICO. A survey of health centers conducted in late 2021 found that nearly 50% of responding health centers reported they have or plan to reach out to their Medicaid patients with reminders to renew their coverage and to schedule appointments to assist them with renewing coverage. That means that this will end on December 31 of this year. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be significant. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. the federal government declared a public health emergency (PHE). However, if the guardrails are too flimsy or non-existent, states could see a surge in their uninsured populations right as government Covid funding runs dry, and individuals will have to depend on health plans to cover tests, vaccines and therapeutics for the virus. This should include an email address and cell phone number if you have them, as states are increasingly using email and text messages, as well as regular mail, to contact enrollees. Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). Lawmakers have struck an agreement to move the end of its Medicaid rules up to April 1, which would allow states to begin removing people from the rolls who no longer qualify, usually because their income has increased. For example, California and Rhode Island are planning to automatically enroll some people who lose Medicaid eligibility into a marketplace plan in their area (although they would still have the normal 60-day window to select a different plan or opt-out if they dont want marketplace coverage). The recent CIB notes that CMS is expected to issue guidance to address how new reporting requirements (discussed below) may intersect with the requirements described in prior CMS guidance. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. That will help us make the concrete plans necessary to make sure this happens in an orderly fashion.. 2716, the Consolidated . How many people will lose Medicaid coverage when the continuous coverage requirement ends? An analysis of state Medicaid websites found that while a majority of states translate their online application landing page or PDF application into other languages, most only provide Spanish translations (Figure 7). But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. This policy update will examine several of the health-related COVID-19 Federal Emergency Declarations and which flexibilities will end in May. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. I was, frankly, a little surprised that Dems were not more willing to cut a deal on this earlier, a health industry lobbyist familiar with negotiations noted to POLITICO. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. Learn more at ConnectForHealthCO.com or 855-752-6749: Get expert help signing up for health coverage by working with a certified assister or broker, online or in person. States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process. Two key public health reauthorizationsthe Pandemic and All-Hazards Preparedness Act (PAHPA) and the President's Emergency Plan for AIDS Relief (PEPFAR)are due for renewal in 2023. If CMS determines a state is out of compliance with any applicable redetermination and reporting requirements, it can require the state to submit a corrective action plan and can require the state to suspend all or some terminations due to procedural reasons until the state takes appropriate corrective action. And all states accepted the additional federal Medicaid funding. According to a KFF survey conducted in January 2022, states were taking a variety of steps to prepare for the end of the continuous enrollment provision (Figure 4). US Department of Health and Human Services Secretary Xavier Becerra . Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. A nationwide public health emergency is in effect. Heres what enrollees need to know. President Biden says the emergency order will expire May 11. To continue, Congress must Act and pass legislation making these waivers continue... 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