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Friday, Aug 11 2023

Full Issue

CMS Dials Up Public Pressure On States Over Medicaid Enrollment Red Tape

The Centers for Medicare and Medicaid Services publicly released warning letters sent to all states over the high number of people losing Medicaid coverage for reasons other than eligibility. At least 36 states are believed to be falling short in one of the key areas of concern: paperwork problems, long call center wait times, or slow application processing.

The Centers for Medicare and Medicaid Services is ramping up pressure on states that may be failing to meet federal requirements as they renew Medicaid coverage for millions of people for the first time since the start of the pandemic. The agency has for months been mum about its behind-the-scenes communications with states, but on Wednesday made public letters it sent to state Medicaid officials warning that they may be running afoul of federal law and regulations. The letters, which were sent to all 50 states and Washington, D.C., identified three key areas of concern: high rates of people losing Medicaid because of paperwork problems, long call center wait times and slow application processing. (Messerly, 8/10)

The Biden administration this week sent letters to state health officials, warning that many are failing to meet federal requirements about determining Medicaid coverage for tens of millions of people in the wake of the pandemic public health emergency. The Centers for Medicare and Medicaid Services (CMS) has expressed concern for months that many states are rushing through the process, resulting in people losing coverage for 鈥減rocedural鈥 reasons even though they may still be eligible.聽(Weixel, 8/10)

In related news from Michigan, Missouri, and Montana 鈥

In June and July, at least 22,911 Michiganders were bumped off the state's Medicaid rolls because they are no longer eligible for benefits or for procedural problems, such as failing to provide complete information like pay stubs, bank statements or driver's license details to state health regulators. That's nearly 5% of the 471,573 people statewide who were due to reenroll in those months, according to data from the Michigan Department of Health and Human Services. (Shamus, 8/11)

The average wait time for a person calling the Missouri state Medicaid helpline in May was almost 50 minutes, according to a letter the federal Centers for Medicare and Medicaid Services sent to state officials. Federal officials are watching how states are removing people from Medicaid since a ban on removing them during the coronavirus pandemic public health emergency ended. This week, they detailed how states are doing in letters to administrators across the country. (Fentem, 8/10)

The federal agency that oversees Medicaid said it鈥檚 concerned with Montana鈥檚 ability to provide customers help over the phone due to long wait times and a high rate of dropped calls. The average wait time for those seeking help through Montana鈥檚 Medicaid call center was 42 minutes during the month of May, which is 5 minutes longer than March and April according to previous data. (Amestoy, 8/10)

On Medicaid reform in Georgia and Idaho 鈥

Gov. Brian Kemp鈥檚 limited expansion of Medicaid that launched July 1 for certain working or active adults has approved 265 people for enrollment in its first month, state officials said Thursday 鈥 a small step towards the 90,000 enrollees Kemp aides hope to enroll after it fully ramps up. Kemp鈥檚 program, which was four years in the making, is meant to address the state鈥檚 health insurance coverage gap: An estimated 370,000 poor Georgia adults have no insurance through a job, but earn too little money to qualify for subsidized plans on the Affordable Care Act marketplace. (Hart, 8/10)

Georgia Democrats who have long pushed for full Medicaid expansion blasted the governor鈥檚 program Thursday. Georgia, which has one of the highest uninsured rates in the country, is one of 10 states that have not expanded Medicaid under the Affordable Care Act. 鈥淎t this rate, it would take 28 years for the Governor to meet this enrollment estimate of 90,000 people. This program is a loser from Day One,鈥 said Senate Minority Leader Gloria Butler, a Stone Mountain Democrat. (Nolin, 8/10)

Idaho doctors asked state legislators on Wednesday to let doctors continue managing health care for people on Medicaid, a health insurance program for the poor.聽Idaho formed a committee of legislators to study how to potentially restructure funding for the state鈥檚 Medicaid program, which uses a growing amount of state funds 鈥斅爑p to $4.5 billion this fiscal year 鈥 but is mostly funded by the federal government. The group, called the Medicaid Managed Care Task Force, is meeting while the rest of the Legislature is out of session. It is expected to deliver recommendations to the Legislature on Jan. 31.聽(Pfannenstiel, 8/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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