Estimates indicate that among full-benefit beneficiaries enrolled at any point in 2018, 10.3% had a gap in coverage of less than a year (Figure 3). For additional resources about the end of the PHE, you can visit the websites below: https://www.cms.gov/files/document/what-do-i-need-know-cms-waivers-flexibilities-and-transition-forward-covid-19-public-health.pdf, https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html, Your email address will not be published. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. Can you appeal your states decision to disenroll you? Update regarding intent to end the national emergency and public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023 Update: On Thursday, December 29, 2022, President Biden signed into law H.R. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. Nursing school is expensive and as a result roughly of nursing students take out federal student loans to help pay for school. instructed providers requesting an extension to specify, as part of their extension request, their plan for finishing their demonstrations of compliance by December 30, 2022. The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. 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. The original date for resumption of payments is June 30 and that is still likely to continue, but if the Supreme Court issues a decision before the end of April that date would change. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. While the share of individuals disenrolled across states will vary due to differences in how states prioritize renewals, it is expected that the groups that experienced the most growth due to the continuous enrollment provisionACA expansion adults, other adults, and childrenwill experience the largest enrollment declines. 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. 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). Both . But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. Now, Democrats are prepared to join them four people close to the negotiations tell POLITICO. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. All orders will be shipped via First Class Package Service. Free or nearly free coverage will be available in the marketplace for people eligible for this special enrollment period (this is a result of the American Rescue Plans subsidy enhancements). 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. The overriding thing state Medicaid agencies want is certainty about what is coming, Jack Rollins, the director of federal policy for the National Association of Medicaid Directors, told POLITICO. The Department of Health and Human Services (HHS) has extended the public health emergency eight times and is currently set to expire in April 2022. US Department of Health and Human Services Secretary Xavier Becerra . CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. Meghana Ammula But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. 2022 Congressional Spending Bill Included Several ANA-Supported Nursing Provisions to Cap off the Year, The End of the Public Health Emergency and What this Means for Nurses, APRNs Can Provide Quality and Access to Care and Congress Needs to Let Them, Introducing the Safe Staffing for Nurse and Patient Safety Act, House Tax Bills Impacts on Nurses and Consumers, House Tax Bills Impacts on Nurses and Consumers Capitol Beat, Better Late, Than Never House and Senate Make Moves on CHIP. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. According to a KFF survey conducted in January 2022, states were taking a variety of steps to prepare for the end of the continuous enrollment provision (Figure 4). (Note that there are several terms that are used interchangeably: Eligibility redetermination, renewal, case review, recertification, and redetermination all mean the same thing, and refer to the process by which the state determines whether a Medicaid enrollee is eligible to continue to receive Medicaid.). endstream endobj 507 0 obj <. 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. The COVID-19 Public Health Emergency (PHE) that was declared in March 2020 is set to end on May 11, 2023, as the President has announced there will be no more extensions to the PHE. And the Consolidated Appropriations Act, 2023 provides for the additional federal Medicaid funding to gradually decrease throughout 2023, instead of ending abruptly at the end of the quarter in which the PHE ends. That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter (TTY) numbers on or within one click of their homepage or online application landing page (Figure 8), but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. 3179 0 obj <>/Filter/FlateDecode/ID[<20F5AF77DB63DC49B2341D6107722670>]/Index[3168 23]/Info 3167 0 R/Length 69/Prev 482993/Root 3169 0 R/Size 3191/Type/XRef/W[1 2 1]>>stream For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. Contact Us, 2023 Center for Children & Families (CCF) of the Georgetown University Health Policy Institute, McCourt School of Public Policy, Georgetown University | 600 New Jersey Ave. NW | Washington, DC 20001 | 202.784.3138, Georgetown Center for Children and Families Homepage, Percent of Children Covered by Medicaid/CHIP by Congressional District, 2018, Percent of Adults Covered by Medicaid/CHIP by Congressional District, 2018, renewed the COVID-related public health emergency. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. 3190 0 obj <>stream Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage. However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online. The lack of certainty is weighing on states and Medicaid stakeholders. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following. Medicaid is a prime example: As of late 2022, enrollment in Medicaid/CHIP stood at nearly 91 million people, with more than 19 million new enrollees since early 2020. Any information we provide is limited to those plans we do offer in your area. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . Most of the people who will become eligible for marketplace subsidies will be adults, as children are always much less likely than adults to qualify for marketplace subsidies. Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. Eligible individuals are at risk for losing coverage if they do not receive or understand notices or forms requesting additional information to verify eligibility or do not respond to requests within required timeframes. Share on Facebook. 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. The recently enacted Consolidated Appropriations Act includes additional reporting requirements for states and imposes penalties in the form of reduced federal matching payments for states that do not comply. assuming the administration keeps its promise, Unwinding Wednesday #22: Updates to 50-State Tracker with One Month Until Unwinding Start Date, Center for Renewing America Budget Plan Would Cut Federal Medicaid Spending by One-Third, Repeal Affordable Care Acts Coverage Expansions, Federal Medicaid Expansion Incentives Offer Another Tool for States to Continue Coverage as Pandemic-Era Medicaid Rules End. hbbd``b`$ = $: " Ms ]@B#F_ E+ The ARP is still making premiums more affordable. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. The state has to make a good-faith effort to find the person first. States can also consider sharing information on consumers losing Medicaid who may be eligible for Marketplace coverage with Marketplace assister programs; however, in a recent survey, few assister programs (29%) expected states to provide this information although nearly half were unsure of their states plans. As COVID-19 becomes less of a threat and the federal government's public health emergency ends, states will restart yearly Medicaid and Children's Health Insurance Program (CHIP) eligibility reviews beginning April 1, 2023. The Public Health Emergency and Extended Medicaid Coverage | Unwind Issues Impacting Miami-Dade County 11/16/2022 This webinar, sponsored by the South Florida Enrollment Coalition, discusses the continuous Medicaid coverage that has been part of the Public Health Emergency, the expected impact on Miami-Dade County residents currently on Medicaid, and what advocates should know in preparation . Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as recent legislation and guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the continuous enrollment provision. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. However, in many states, the share of renewals completed on an ex parte basis is low. By law, public health emergencies are declared in 90-day increments. Medicaid and CHIP Services Information for People Receiving Services English Espaol In response to the COVID-19 pandemic, the federal government declared a public health emergency (PHE) and passed a law that allowed you to automatically keep your Medicaid coverage (continuous Medicaid). Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals (the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe). The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. Its understandable that a primary goal of the redetermination process is to ensure that these individuals transition to other coverage, either from an employer or through the exchange/marketplace. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. If BBB had been enacted in December, states would have had three months to get ready. President Biden says the emergency order will expire May 11. Would love your thoughts, please comment. %%EOF 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 Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. With respect to Medicare: We do not offer every plan available in your area. Omnibus spending bill allows states to resume Medicaid eligibility redeterminations in April. That will resume in April 2023.). That will help us make the concrete plans necessary to make sure this happens in an orderly fashion.. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. Medicaid eligibility redeterminations will resume in 2023. The U.S. Department of Health and Human Services (HHS) must renew the federal public health emergency (PHE) related to COVID-19 every 90 days to maintain certain health care flexibilities and waivers. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. People using this window can, If youre eligible for Medicare, youll have. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. And some states that also offer additional state-funded subsidies allow people with higher incomes to enroll year-round. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). According to a survey of non-profit, safety net health plans that participate in Medicaid, states are partnering with these MCOs in multiple ways. This JAMA Forum discusses the potential ramifications after the COVID-19 public health emergency ends such as limiting telehealth, ending the continuous enrollment requirement in Medicaid, and decreasing regulatory flexibility that has allowed pharmacists to administer COVID-19 vaccines. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. 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. Dig Deeper Medicaid Spending on. HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. A PHE can be extended as many times as deemed necessary by the Secretary. 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