Medicaid rescheduling results in cancellation of many enrollments

Arkansas removed more than 72,000 people from Medicaid in April, the first month states could begin trimming program rolls. Those affected who believe they may still qualify for coverage may provide the state with the missing information to maintain or reinstate benefits, a spokeswoman for the Arkansas Department of Health Services wrote in an email. Is.

In Florida, nearly 250,000 Medicaid enrollees lost coverage last month, more than 82.2% of them for procedural reasons. The Florida Agency for Health Care Administration did not respond to interview requests.

Indiana has the highest ever procedural denial rate of 88.5%. A spokeswoman for the Indiana Family and Social Services Administration wrote in an email that the state’s Medicaid roll reached 2.2 million during the pandemic. The spokesperson wrote that some enrollees may not have responded to the state’s requests because they know they are no longer eligible. In addition to sending notices, sending text messages and making telephone calls to beneficiaries, the agency is running a paid advertising campaign, the spokesperson wrote.

States investing in new technology systems, training army of brokers And Partnering with health insurance companies and providers To minimize coverage loss.

Despite this effort, most Medicaid beneficiaries are unaware that states have reintroduced eligibility checks, according to survey results published Wednesday by the Kaiser Family Foundation. Sixty-five percent of respondents did not know about Medicaid rescheduling and another 7%—disproportionately black or Hispanic—wrongly believe that states are not allowed to cut people from the program. Nearly 30% said they don’t know where to get replacement coverage and 15% expect to be uninsured.

Lucy Dagneau, senior director of state and local Medicaid campaigns at the American Cancer Society Cancer Action Network, said CMS should require states with high levels of procedural denials to submit corrective action plans or prevent rescheduling. “What we are concerned about is that it doesn’t seem clear that states know essentially why their procedural denial rates are so high,” she said.

Long call center wait times, mail delays and fraud reporting further complicate the process for enrollees.

For example, West Virginia is reviewing other states’ Medicaid systems to see if their residents are covered elsewhere. If an enrollee has an open file in another state, West Virginia removes them from Medicaid and begins a fraud investigation, said Miriam Delaney Hurd, a senior attorney with the National Health Law Program. To restore West Virginia Medicaid coverage, beneficiaries would have to close their files in other states and prove they weren’t committing fraud, she said.

“They need a person to close a case in another state. How is that possible?” Delaney Hurd said. “You call into these call centers and cannot get through to anyone and yet, whatever state they have come from, they are also going through rescheduling. How high is this going to go up on their radar?” The West Virginia Bureau for Medical Services did not respond to interview requests. The state has not released updated enrollment data.

In South DakotaMore than 1,700 people lost Medicaid coverage in April, who will become eligible State Medicaid Expansion Effective from 1st July. The South Dakota Department of Social Services declined to comment.

North Carolina also set to expand Medicaid after state made a policy in March. Jay Ludlam, North Carolina’s deputy director of Medicaid, said North Carolina will begin rescheduling in July, months before the expansion takes effect. In the meantime, the state plans to assist those who leave Medicaid with finding replacement coverage and then enroll eligible people in expanded Medicaid when it becomes available, he said.

“They don’t have to do any paperwork. It would be seamless for them. They’ll get enrolled in the expansion population,” Ludlam said.

Arizona Medicaid, known as the Arizona Health Care Cost Containment System, was dropped from 33,705 people who signed up for Medicaid during the federal public health emergency and 6,126 people who had Medicaid before the COVID-19 pandemic, spokeswoman Heidi Capriotti he said.

Arizona tracked enrollment information continuously during the pandemic, which enabled the state to more easily assess which beneficiaries are most likely to no longer be eligible, she said. In addition, rescheduling state employees did not require training or retraining, Capriotti said. “I would say the process is going about as smoothly as expected,” she said.

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