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Today,
the Centers for Medicare & Medicaid Services (CMS) released a State
Health Official (SHO) letter outlining new requirements in the
Consolidated Appropriations Act, 2023 that impact state activities for
the Medicaid and CHIP (Children’s Health Insurance Program) programs to
unwind from the COVID-19 public health emergency. The SHO also addresses
changes to the conditions which states must meet to receive increased
federal medical assistance percentage (FMAP), reporting requirements, and
new enforcement authority for CMS to ensure state compliance with
eligibility redetermination and reporting requirements.
Read
the letter at: https://www.medicaid.gov/federal-policy-guidance/downloads/sho23002.pdf
In
addition, CMS released information on a temporary Exceptional
Circumstances Special Enrollment Period (SEP) for consumers losing
Medicaid or CHIP coverage due to unwinding of the Medicaid continuous
enrollment condition. From March 31, 2023 and lasting through July 31,
2024, the Marketplaces using the Federal platform will be providing
additional flexibility for Marketplace-eligible consumers losing Medicaid
or CHIP to enroll in Marketplace coverage during and immediately
following the end of the Medicaid Continuous Enrollment Condition
unwinding period. This flexibility will be provided by facilitating
access on HealthCare.gov to an SEP, referred to as the “Unwinding SEP.”
Read the guidance at: https://www.cms.gov/technical-assistance-resources/temp-sep-unwinding-faq.pdf
CMS previously announced a
Medicare Special Enrollment Period to help individuals who did not sign
up for Medicare on time and lose Medicaid coverage. This new SEP helps
promote seamless transitions from Medicaid to Medicare coverage and
removes Medicare late enrollment penalties. More information on Medicare
Special Enrollment Periods can be found at: https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan/special-circumstances-special-enrollment-periods
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