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November 2021 Medicaid Changes

November 2021 Medicaid Changes

Health Exchange Open Enrollment 

Open Enrollment is now open until January 15th.  

Public Health Emergency 

The Public Health Emergency (PHE) renewed on October 18th to last for another 90 days. 

Medicaid State of the Union 

Colorado 

The Colorado Option passed and is set to implement in 2022, with the bulk of changes going into effect in 2023. Earlier this month, the state officials met with hospitals and other stakeholders outlining the plan to resume back to normal Medicaid operations.  

Florida 

Last month, WellCare and Staywell merged with Sunshine State Health Plan.  

Indiana  

CMS approved the state’s amended 1115 waiver titled the Health Indiana Plan (HIP). Some recipient requirements remain such as contributing to POWER accounts if above 100% FPL, tobacco user surcharge, cost sharing and it waives retroactive eligibility. The waiver did not include requirements of employment to remain for Medicaid. The state posted information in August that a HIP basic member will be sent a letter asking for payments, but the state advised to ignore the payments while they are still within the PHE. More information can be found here. 

Kansas 

BlueCross BlueShield of Kansas and of Kansas City are partnering to submit a proposal on the new KanCare contract. The goal is for the new alliance to be called “Health Blue” and serve the managed Medicaid population within the state. 

Missouri 

Missouri voters approved Medicaid expansion, but it was not funded through the legislative sessions. After legal battles, the Missouri Supreme Court ruled expansion as constitutional and ordered that the application process begin.  

The state was ordered to begin accepting applications in August but was not able to start processing those applications until October. More than 17,000 individuals have applied, and an estimated 275,000 Missouri residents could be eligible.  

Nevada 

Nevada is working on winding down Medicaid flexibilities post-PHE, but has not published the full plan. Beginning in January 2022, the state will now have four managed Medicaid plans for recipients to choose from.  

South Carolina 

South Carolina Department of Health and Human Services (SCDHHS) is adding an additional managed care organization (MCO) to serve Healthy Connections Medicaid members. Although South Carolina is one of 12 states who has not expanded Medicaid coverage, the governor has expressed that the state will not amend its stance, even with the additional dollars at play from the American Rescue Plan.  

Texas 

The Texas Health and Human Services Commission (HHSC) released a request for proposals for the procurement of Texas STAR Health, the state’s Medicaid managed care program for children and young adults in foster care. Responses are due by December 6th, with awards anticipated in June 2022. HHSC will award one, six-year contract beginning August 2022, with up to three, two-year renewals. Historically, the contract has been worth $361 million annually. Implementation is expected September 2023. 

Governor Abbot also recently announced a $310 million in emergency SNAP benefits which is expected to provide food to 1.5 million households and renewed the COVID-19 Disaster Proclamation for all counties in Texas on October 28th.