State and federal Medicaid programs are ever-changing, and dynamic responses to the COVID-19 pandemic are no exception. The Social Security Administration (SSA) and Medicaid offices are closed and processes are changing weekly, if not daily. State Medicaid agencies are making changes to offset the impact of COVID-19 to help protect their staff while ensuring patients are still able to get coverage.
According to the Washington Post, the United States unemployment total surpassed 22 million people in four weeks since the nation declared a national emergency. In the coming months, the need for coverage and financial assistance will significantly increase due to furloughs and layoffs as a result of COVID-19.
And, the healthcare industry has had to shift gears and navigate the complexities of screening patients telephonically when needed as hospitals restrict visitors. Additionally, patient advocates are working around isolation protocols, finding alternate routes to best obtain documentation.
Some Medicaid programs are allowing presumptive Medicaid flexibilities, allowing for verbal consent on the Medicaid full application. Additionally, some states are allowing a self-attestation of income and annual "lapse of coverage" reapplications are being eliminated. Lastly, States have issued 1135 Waivers as an emergency response to create flexibility within Medicaid programs.
Below we breakdown the latest Q2 Medicaid regulation changes, federal Medicaid process updates and state agency closures.*
Here are key 2020 Medicaid changes in Q2:
All local Social Security offices are closed for in-person traffic but are available via phone. TERI case phone appointments are available every day. All DDS offices have canceled consultative exams. All in-person activity for SSA hearings have been suspended and teleconferences will be set-up to conduct hearings.
Alabama Medicaid COVID-19 Updates
The state of Alabama has implemented temporary work schedules but is still providing essential Medicaid services. On March 20, CMS approved the state's 1135 waiver request which allows for flexibilities on pre-admission screening and annual resident review level I and level II assessments for 30 days.
Alaska Medicaid COVID-19 Updates
Alaska's Medicaid office is closed to the public but is operating without delays through online resources and phone calls.
California Medicaid COVID-19 Updates
Each county in California's COVID-19 response varies, with some having employees working from home while others working split shifts. LA County offices are closed to the public; staff are still processing cases, its call center remains open and people are encouraged to apply online. The state of California is exploring the option of having the patient apply for Medicaid without a signature. An 1135 waiver was approved on March 23 allowing for flexibilities with pre-authorization, fair hearing requests and provider enrollment
Colorado Medicaid COVID-19 Updates
Adams, Arapahoe, Archuleta, Boulder, Denver, Eagle, Jefferson, Lake and San Juan counties are closed, but all staff members are working remotely.
Connecticut Medicaid COVID-19 Updates
Operating as normal.
Florida Medicaid COVID-19 Updates
DCF offices are closed to the public, however, contact will be conducted through its call center and online applications.
The state submitted and received an approval on the 1135 Waiver. The waiver allows flexibility with provider enrollment, some prior authorization requirements, services in alternative settings and state fair hearing request and appeals.
Beyond the COVID-19 crisis, SB 52 would make permanent the limitation on Medicaid retroactive eligibility from 90 days to 30 days in the same calendar month that an application is submitted. The bill was not approved on a permanent basis but is reapproved for one more year. The clarification language was rejected that would have allowed the date of service to be the date the application was submitted and not the date it was received by the state.
Georgia Medicaid COVID-19 Updates
All offices are closed to the public and DFCS staff are working from home or in the office with no public contact.
Hawaii Medicaid COVID-19 Updates
Hawaii sent all EWs from its main office to work-from-home and call center representatives are working remote as well.
Idaho Medicaid COVID-19 Updates
Operating as normal.
Indiana Medicaid COVID-19 Updates
The governor held a press conference on Friday, April 17th promoting "Hunker Down Hoosiers" that state employees would work-from-home. We are continuing research on how this will specifically impact Medicaid employees.
Kansas Medicaid COVID-19 Updates
Kansas has adjusted its operating hours.
Kentucky Medicaid COVID-19 Updates
Kentucky offices are closed to the public, extending call center hours and reassigning case workers to call centers. Due to the COVID-19 pandemic, the 1135 waiver was approved on March 25. This waiver includes flexibility on authorization requirements, pre-admission screening, provider enrollment and hearing/appeal timelines. We've received instruction from Kentucky that PE applications can be submitted with verbal consent and self-attestation of income.
Mississippi Medicaid COVID-19 Updates
Mississippi offices are closed to the public but are available via phone. On March 23, Mississippi received an approval for the 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 COVID-19 Updates
Missouri has extended its call center hours.
Montana Medicaid COVID-19 Updates
Operating as normal.
Nevada Medicaid COVID-19 Updates
Nevada State Welfare offices are closed to the public and some staff are working from home but are still fielding calls and answering questions.
New Hampshire Medicaid COVID-19 Updates
New Hampshire is handling office hours and appointments via phone.
North Carolina Medicaid COVID-19 Updates
North Carolina is modifying schedules and allowing staff to work remote. DSS offices remain open, but they are encouraging online applications.
Oklahoma Medicaid COVID-19 Updates
Operating as normal.
Oregon Medicaid COVID-19 Updates
Oregon has all of its employees working from home.
South Carolina Medicaid COVID-19 Updates
Offices are closed for in-person activity, and applications can be processed online. Staff are available via phone.
Tennessee Medicaid COVID-19 Updates
Tennessee offices are operating as normal. The state has added a few flexibilities such as allowing verbal consent of presumptive, full and emergency Medicaid applications, authorization and birth reporting form. They are pushing terminations for both Medicaid and Cover Kids, and accepting self-attestation of income and resources. The 1135 waiver was approved on March 31—it does not have a direct impact on Medicaid eligibility but it does allow for flexibility around pre-admission screening, provider, enrollment and provision of services in alternative settings.
Texas Medicaid COVID-19 Updates
Each county's COVID-19 response varies while some staff working remote, but all offices remain open as they encourage recipients to apply online.
Utah Medicaid COVID-19 Updates
Utah removed all outreach workers from the facilities. Applications are accepted online. Staff can be contacted via phone and verifications can be sent via fax or mail.
Virginia Medicaid COVID-19 Updates
All DSS offices are closed to the public but applications can be submitted presumptively, via drop box or online. Hold times are increasing with Cover VA and SSA. We have sent a request to the state to see if any flexibilities will be created allowing for verbal consent of the application and the authorized representative form. The state has acknowledged the receipt of our request and is discussing internally. On March 23, CMS also approved an 1135 waiver providing additional flexibility to hearing/appeal timelines, and prior authorizations.
West Virginia Medicaid COVID-19 Updates
West Virginia is in the process of transitioning its onsite casework to work-from-home.
*This article was originally published April 22, 2020.