public health emergency extension 2022 medicaid

CLARIFICATION: This report has been updated to clarify that the Congressional Budget Office expects the public health emergency for Covid will expire in July, barring another extension. 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. 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. A PHE can be extended as many times as deemed necessary by the Secretary. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. This will be the case, for example, for someone who was enrolled under Medicaid expansion guidelines (which only apply through age 64) and has turned 65 during the PHE. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. And if this passes, Congress will essentially give states a 98-day notice.. as proposed in the Build Back Better Act (BBB)? That's at least in part due to 2020's Families First Coronavirus Response Act, which required state Medicaid programs to keep beneficiaries enrolled through the duration of the pandemic. 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. Helping millions of Americans since 1994. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. Medicaid eligibility redeterminations will resume in 2023. But we need to leverage every method to reach people on the program.. In January 2020, the federal government enacted a national public health emergency that has since served as the "primary legal pillar of the U.S. pandemic response." 1 The emergency. With respect to Medicare: We do not offer every plan available in your area. 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. During the PHE, Medicaid agencies have not disenrolled most members, even if someone's eligibility changed . Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. States will be eligible for the phase-down of the enhanced FMAP (6.2 percentage points through March 2023; 5 percentage points through June 2023; 2.5 percentage points through September 2023 and 1.5 percentage points through December 2023) if they comply with certain rules. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. 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. The Biden administration announced its intention to end the federal public health emergency on May 11, 2023. Further, states must also comply with federal rules about conducting renewals. There is no doubt that some people currently enrolled in Medicaid are no longer eligible due to income increases since they enrolled in the program. 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. Without other action, states can start disenrolling people beginning May 1, 2022. Churn can result in access barriers as well as additional administrative costs. The most recent draft of the BBB would have begun to phase out the enhanced FMAP in the second and third quarters of the year (April September 2022) and, if it becomes law as written, states would be allowed to restart renewals as of April 1st. Heres what enrollees need to know. Can I use my Medicaid coverage in any state? 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 Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . during which you can transition to Medicare without any late enrollment penalties. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). Collectively, these metrics are designed to demonstrate states progress towards restoring timely application processing and initiating and completing renewals of eligibility for all Medicaid and CHIP enrollees and can assist with monitoring the unwinding process to identify problems as they occur. How the COVID relief law will rescue marketplace plan buyers, If you have access to an employer-sponsored health plan, your loss of Medicaid coverage will trigger a special enrollment period that will allow you to enroll in the employer-sponsored plan. Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision, 10 Things to Know About Medicaid Managed Care, FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools, Health Insurer Financial Performance in 2021. And yet, many states have indicated they need more not less lead time. The latest extension will expire on April 16, 2022. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. The Center for Children & Families (CCF), part of the Health Policy Institute at the McCourt School of Public Policy at Georgetown University, is a nonpartisan policy and research center with a mission to expand and improve high-quality, affordable health coverage. The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. Can you appeal your states decision to disenroll you? October 17, 2022. Its noteworthy that the additional federal Medicaid funding that states have received is more than double the extra cost that states have incurred to cover the FFCRA-related enrollment growth. As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the continuous enrollment provision, and phases down the enhanced federal Medicaid matching funds through December 2023. 4. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. There are millions of people who became eligible for Medicaid at some point since March 2020, and are still enrolled in Medicaid even though they would not be determined eligible if they were to apply today. The lack of certainty is weighing on states and Medicaid stakeholders. Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. There are a number of waivers that ANA would like to become permanent. You can share your story about the impact of the Public Health Emergency HERE. Outside GOP advocates working closely with Congress argued that if those guardrails are built too high, the policy move might not yield the federal revenue thats driving the discussion in the first place. Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. The Administration's plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. During the PHE, Medicaid enrollees automatically stayed enrolled in Medicaid and did not have to constantly keep proving eligibility. US Department of Health and Human Services Secretary Xavier Becerra . It also provides states more time to prepare for new rules that will put millions in jeopardy of losing their health insurance, something state Medicaid directors have been demanding from legislators. The Centers for Medicare & Medicaid Services (CMS) implemented several interim final rules during the PHE. This provision requires states to provide continuous coverage for Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding. %%EOF 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. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. Similarly, a survey of Marketplace assister programs found that assister programs were planning a variety of outreach efforts, such as public education events and targeted outreach in low-income communities, to raise consumer awareness about the end of the continuous enrollment provision (Figure 9). On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public . Verify that your information is correct and select Place My Order. So HHS has finalized a rule change that allows for a six-month special enrollment period during which a Medicare-eligible person who loses Medicaid coverage can transition to Medicare without a late enrollment penalty. endstream endobj startxref A majority of responding MCOs reported that they are sending updated member contact information to their state; nearly all said their state is planning to provide monthly files on members for whom the state is initiating the renewal process and more than half indicated that information would include members who have not submitted renewal forms and are at risk of losing coverage; and more than half of plans reported their state is planning to provide periodic files indicating members whose coverage has been terminated . 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). If you no longer meet your states Medicaid eligibility guidelines, its a good idea to understand what your options will be when your state begins disenrolling people who are no longer eligible. But even if youre eligible for this ongoing special enrollment period, its still in your best interest to submit an application as soon as possible if you find out that youll be losing your Medicaid coverage. 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. For enrollment reporting, states will provide baseline data at the start of the unwinding period related to applications, enrollment, estimated timeframe for completing initiated renewals, and fair hearings, and then states will submit monthly reports that will be used to monitor these metrics throughout the unwinding period (Figure 10). Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. Democrats want to make that harder, but if they put too many restrictions on states ability to do that, Im not sure how the math would work out. By law, public health emergencies are declared in 90-day increments. As a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. The primary things to keep in mind: Your Medicaid coverage will continue if you continue to meet the eligibility guidelines and submit any necessary documentation as soon as its requested by the state. 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. You may have to submit documentation to the state to prove your ongoing eligibility, so pay close attention to any requests for information that you receive. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. Or maybe your circumstances have changed perhaps your income is the same but you have fewer people in your household and your income now puts you at a higher percentage of the poverty level. In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. These waivers include strategies allowing states to: renew enrollee coverage based on SNAP and/or TANF eligibility; allow for ex parte renewals of individuals with zero income verified within the past 12 months; allow for renewals of individuals whose assets cannot be verified through the asset verification system (AVS); partner with managed care organizations (MCOs), enrollment brokers, or use the National Change of Address (NCOA) database or US postal service (USPS) returned mail to update enrollee contact information; extend automatic enrollment in MCO plans up to 120 days; and extend the timeframe for fair hearing requests. On January 30, the Biden Administration announced May 11, 2023, as the targeted end date for the national public health emergency (PHE) declarations implemented during the COVID-19 pandemic. Overall enrollment increases may reflect economic conditions related to the pandemic, the adoption of the Medicaid expansion under the Affordable Care Act in several states (NE, MO, OK), as well as the continuous enrollment provision included in the Families First Coronavirus Response Act (FFCRA). Total Medicaid/CHIP enrollment grew to 91.3 million in October 2022, an increase of 20.2 million or more than 28.5% from enrollment in February 2020 (Figure 1). The resumption of eligibility redeterminations is no longer linked to end of public health emergency. The PHE is expected to continue until mid-May 2023. The COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start processing eligibility determinations as of April 1, 2023. Meghana Ammula These enhanced reporting metrics require states to report the total number of individuals renewed and those renewed on an ex parte basis, break out Medicaid terminations for childrens coverage and pregnancy-related coverage, report the number of individuals whose coverage was terminated for procedural reasons, including breakouts for childrens coverage and pregnancy-related coverage, and report total call center volume, average wait time, and average abandonment rate. Opens in a new window. The continuous coverage provision increased state spending for Medicaid, though KFF has estimated that the enhanced federal funding from a 6.2 percentage point increase in the federal match rate (FMAP) exceeded the higher state costs. Several interim final rules during the PHE, Medicaid coverage can end as early as April 1,.! Specific guidance allowing states to permit MCOs to update enrollee contact information facilitate. 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