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Three years after states’
annual efforts to verify enrollees’ Medicaid eligibility were paused because
of the COVID-19 public health emergency (PHE), states as of April 1 may begin
terminating Medicaid coverage for individuals who no longer qualify. States
and their managed care partners have been working to update beneficiary
contact information for the inevitable return of redeterminations, and
Medicaid managed care organizations can play a big role in raising awareness
about the process, according to industry experts.
States will have to work
hard on outreach
- “I think that
many members, probably 60% to 70% of folks, are just completely unaware
that this is happening, and a lot of other folks just don’t realize the
rigmarole they have to go through in order to maintain eligibility,”
remarks Jerry Vitti, founder and CEO of Healthcare Financial, Inc.
“But plans can do mailings, do outreach, and be a connection point to
Medicaid agencies where they can get enrolled.”
- Unfortunately,
“they have uneven demographic information on these folks since the
population is so transient, but they can reach out to members…and I
think plans can do a really good job to build awareness of what’s
happening and the implications.”
- CMS has
previously explained that states will have up to 12 months to begin —
and 14 months to complete — eligibility redeterminations for all
individuals following the end of the continuous enrollment condition.
Colorado and Nevada will
lean on MCOs
- During a Jan.
27 public
meeting of the Medicaid and CHIP Payment and Access
Commission (MACPAC), representatives from Colorado and Nevada outlined
their state agencies’ plans for conducting renewals.
- According to
Chris Underwood, chief administrative officer with the Colorado Dept. of
Health Care Policy and Financing, the state has done a lot of work
electronically to update online options and enable individuals to
complete their renewals online.
- Colorado has
also provided toolkits to its managed care partners on updating
addresses, the timing of renewal packages, etc. Two weeks prior to any
termination, the state is asking its MCOs to make follow-up phone calls
to individuals and keep track of who’s submitted their applications.
- Since about 75%
of Nevada’s Medicaid enrollees are in a managed care plan, “we relied
heavily on them because they have the marketing budgets, they have the
ability to use things that states aren’t able to use like Tik Tok and
[other] nontraditional communication methods,” remarked Sandie Ruybalid,
deputy administrator with the Nevada Dept. of Health and Human Services
(DHHS).
- The state is
also now rolling out weekly communications over social media and email
and distributing a short survey for managed care plans to share with
members about the return of redeterminations, how to update their
address, etc. “It’s both educational and inquisitive, and we can then
target on where the weaknesses are…and try to gear up and make sure that
we’re covering everything” for beneficiaries.
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