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May 2020 Medicaid Changes

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May 2020 Medicaid Changes

State and federal Medicaid programs are seeing an increase in demand due to response from COVID-19 furloughs and layoffs. In the coming months, the need for coverage and financial assistance will significantly increase, with the Congressional Budget Office estimating the United States unemployment rate to exceed 15% through September.

As a result, the healthcare industry has had to shift gears operationally to ensure the general public knows it is still safe to seek healthcare, and that patients are screened via telephone for coverage when needed.

Some programs have presumptive Medicaid flexibilities, allowing for verbal consent on the Medicaid application. Additionally, some states are allowing a self-attestation of income and annual "lapse of coverage" reapplications are being eliminated.

Parallon is continuously tracking the status of emergency response 1135 Waivers, Medicaid and Social Security office closures and Medicaid application processing delays.

In addition to Medicaid changes, the COBRA health insurance-continuation program has made adjustments as well, including the removal of the 60-day coverage election period. This new guidance went into effective March 1st and will continue 60 days after the state of emergency has ended.

Below we breakdown the latest subsidized coverage changes for May 2020, federal Medicaid process updates and state agency closures.*

  

Here is the May 2020 Medicaid State of the Union:

 

Alabama Medicaid Updates

Effective March 23, CMS approved Alabama’s 1135 waiver request which allows for flexibilities on pre-admission screening and annual resident review level 1 and level 2 assessments for 30 days.                                   

Alaska Medicaid Updates

Offices are still closed to the public due to the COVID-19 pandemic but we are submitting applications online and following up by phone. They have relaxed the renewal process and applicants who are up to reapply for Medicaid will remain on the program until next year.                                                                                                                                                                              

California Medicaid Updates

The state of California is still requiring signatures on full applications and the authorized representative form. However, we received a memo stating the approval of immediate enrollment flexibility for presumptive Medicaid and using telephonic signatures for those with COVID-19 which is helping mitigate some of the face-to-face contact.                                                                                       

Colorado Medicaid Updates

Many of the counties in the state are closed and not accessible for the public, but all staff members are working remotely.

Connecticut Medicaid Updates

Effective March 27, CMS approved an 1135 waiver for the state that allows flexibilities in prior authorization requirements, hearing/appeal timelines, provider enrollment and provision of services in alternative settings.

Florida Medicaid Updates

DCF offices are closed to the public, but the call center and online application processing remains in place.               

Georgia Medicaid Updates

Most of Georgia’s SSA staff is now working from home. DFCS lobbies are closed to the public but employees are working from home and processing applications.       

Hawaii Medicaid Updates

On March 26, CMS approved the 1135 waiver for the state. The waiver allows flexibilities for some prior authorization requirements, pre-admission screening, hearing/appeal timelines, provider enrollment and provision of services.

In light of COVID-19, we are making sure there are ways to assist the patient without signatures. We are able to apply online through the navigator portal with verbal consent from the patient and no authorized representative forms are needed. DHS offices are open to the public but have reduced staff and some are working from home.       

Idaho Medicaid Updates

Operating as normal.

Indiana Medicaid Updates

The state has suspended fast track payments and suspended provider enrollment revalidation.                                                                                                                                                                                                               

Kansas Medicaid Updates

Kansas Medicaid expansion is still in the hands of the Senate committee as lawmakers are debating a constitution amendment on abortion as one of the main supporters of the bill has stepped down from his position.

Kentucky Medicaid Updates

There have been no major delays with processing so far since the state created flexibilities which includes PE applications that can be submitted with verbal consent and a self-attestation on income.                                                                                                               

Louisiana Medicaid Updates

On March 23, the state received an approval for an 1135 waiver. The waiver provides flexibilities on pre-admission screening, hearing/appeal timelines, provider enrollment and provision of services in an alternative setting.

Mississippi Medicaid Updates

Medicaid in-person offices are closed due to COVID-19, caseworkers are available by phone and patients are able to apply online with no signature.

On March 23, the state received an approval for an 1135 waiver. The waiver provides flexibilities on pre-admission screening, hearing/appeal timelines, provider enrollment and provision of services in an alternative setting.

Missouri Medicaid Updates

In response to COVID-19, Missouri has expanded coverage for people ages 19-64 who have tested positive for COVID-19 and fall below the income/resource guidelines. They have extended their call center hours and are anticipating being able to process these applications within 2-3 business days. If approved, healthcare coverage will last for 90 days.                                                                                                      

350,000 signatures supporting a Medicaid expansion were gathered—twice as many signatures needed to put Medicaid expansion on the November ballot. Although there is support throughout the state, the governor and other elected officials could also block the proposal.                                                                                                                                                                                                               

Montana Medicaid Updates

In light of COVID-19, we are making sure there are ways to assist the patient without signatures and there appears to be no delays or issues with state process timelines at the moment. 

On March 30, CMS approved the 1135 waiver for the state. The waiver allows flexibilities for some prior authorization requirements, pre-admission screening, hearing/appeal timelines, provider enrollment and provision of services in alternative settings.                                                                                                                                       

Nevada Medicaid Updates

DWSS lobbies are closed to the public but staff is working in the office or from home. No electronic signature is required but a paper authorized rep form is completed at the moment.

New Hampshire Medicaid Updates

The state is not allowing in-person office hours but handling everything via phone or email. 

North Carolina Medicaid Updates

The state has loosened some of their guidelines such as allowing applications to be submitted via phone and email along with a verbal attestation. They have a freeze on terminating benefits unless the beneficiary moves out of state or voluntarily terminates eligibility.                                                                                                                                    

Oregon Medicaid Updates

On March 25, CMS approved the 1135 waiver for the state. The waiver allows flexibilities on some prior authorization requirements, pre-admission screening, hearing/appeal timelines, provider enrollment and provision of services in alternative settings. Also, Oregon is not canceling coverage for anyone currently enrolled in the program. The state is waiving income verification or they're allowing self-attestation of income.         

South Carolina Medicaid Updates

Eligibility offices are closed to walk-in traffic but we are still able to apply online and follow-up via customer service. 

Tennessee Medicaid Updates

Offices are operating as normal and the state has added a few flexibilities such as allowing verbal consent of presumptive, full and emergency Medicaid applications, authorization and birth reporting forms. They have paused terminations for both Medicaid and Cover Kids, and accepting self-attestation of income and resources.                                                                                                     

Tennessee submitted an 1115 waiver in April that would provide additional funds to providers treating patients with COVID-19. It does not expand the population of recipients receiving Medicaid, but would better financially support the reimbursement of the COVID-19 diagnosis.                                                                                                     

Texas Medicaid Updates

Once the state’s MMIS system was updated last year, they now have technology in place to adhere to their rule which requires families to renew their eligibility information several times per year instead of the annual renewal that most states have. Due to COVID-19, Texas has relaxed on the renewal process.

Utah Medicaid Updates

Applications may be submitted online without patient signature.         

Virginia Medicaid Updates

All DSS offices are closed to the public. However, applications can be submitted presumptively, via drop box or online.   

                                                                                   

*This article was published on May 27, 2020.