October 2020 Medicaid Changes

Parallon’s eligibility and advocacy team continues to monitor the state of Medicaid eligibility as impacted by COVID-19. Notably, the Department of Health and Human Services extended the federal health emergency another 90 days. The extension will now run from October 23, 2020 to January 21, 2021. In addition, the approval to expand Medicaid in Missouri and Oklahoma and the COVID-19 pandemic is causing several grassroots organizations to gain momentum, especially in the southern states.

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

Here is the October 2020 Medicaid State of the Union:

Alaska Medicaid Updates

Anyone currently on Medicaid will stay active without having to renew until next year. Additionally, offices are staffing in person but most of the offices will only have the public come in person by appointment only.

Florida Medicaid Updates

Offices are closed to the public but call center and online application processing remains in place. Florida has the second highest uninsured rate that increased to 25% from the 13% in 2018.

Georgia Medicaid Updates

New enrollment figures show that Medicaid membership grew by 23,000, while PeachCare, saw enrollment rise by 14,000. Although enrollment is growing, Georgia has the fourth highest uninsured rate at 23%.

Idaho Medicaid Updates

Other than the approved 1135 waiver several months ago, there have not been any additional flexibilities for the Medicaid process in Idaho.

Indiana Medicaid Updates

The state published a memo outlining relaxed rules stating "Eligibility will be determined based on the answers given on the application and will not require supporting documentation".              

Kansas Medicaid Updates

Medicaid expansion was stuck in the Senate but eventually did not pass the senate therefore the state will not pass Medicaid expansion in 2020.

The state decided to part ways with the Maximus who assisted the state with processing Medicaid applications among other duties. Beginning 2021 the duties will not be handled in-house as the state has hired the New Jersey based company Conduent.

Kentucky Medicaid Updates

Governor Andy Beshear notified CMS that Kentucky plans to transition back to the Kynect system, with a fully state-run exchange by the fall of 2021. For the 2021 enrollment period beginning 11/1/2020 the state will be going through the healthcare.gov platform until the following year.

Louisiana Medicaid Updates

Medicaid members who are approved on or after March 18 for Emergency Medical Services (EMS) will remain open for the duration of the COVID-19 emergency period. The Medicaid Eligibility Verification System (MEVS) will not show an end date for EMS coverage as it normally would.

The Louisiana Department of Health issued a Request For Information (RFI) for participation in creating an innovative Medicaid platform. The request is geared towards vendors with innovative ideas as it relates to health disparities and venerable populations. The Louisiana Department of Health announced several new leadership positions have been filled including the Medicaid executive director and Deputy Director of Eligibility. All positions are effective October 1 2020.

Mississippi Medicaid Updates

A push for Medicaid expansion is happening in several southern states but there appears to be an extra push in Mississippi, led by advocacy groups such as Mississippi Health Advocacy Program and the Mississippi Center for Justice.

Missouri Medicaid Updates

Medicaid enrollment numbers have jumped nearly 100,000 people since COVID-19. July 2021 Medicaid expansion will begin and its predicted Medicaid enrollment will increase to about 230,000 people.

Nevada Medicaid Updates

DWSS lobbies are beginning to open back up but still limiting face to face appointments and still processing everything mostly online.

New Hampshire Medicaid Updates

The state is allowing in-person office hours for emergencies (homeless/food needs) and by appointment only. Everything else is handled via phone or email.

LTC application turnaround time previously increased because of only one person processing these applications for the state. They have hired more LTC caseworkers but were still in the onboarding/training process last month. This month average days from filed to approved totals shrank drastically. As for now the issue appears to have been resolved.

North Carolina Medicaid Updates

Legislators overwhelmingly approved a Medicaid package that increases next year’s funding by over $460M and directs the program to begin its long-delayed shift from traditional payments to managed care by July 2021. The federal Declaration of Emergency that was scheduled to end July 25, 2020, but now appears to be ongoing.

NC Medicaid has extended its COVID-19 related temporary Clinical Coverage Policy provisions to Dec. 31, 2020.

Oklahoma Medicaid Updates

Voters narrowly approved Medicaid expansion on June 30, 2020 and is set to begin July 1, 2021. It is estimated 200,000 new members will be eligible. The state is now in the planning and budgeting stages which has already hit a few snags on how the state will pay for the portion of Medicaid expansion not covered by the federal government.

Tennessee Medicaid Updates

In November 2019, the state submitted a controversial 1115 waiver to CMS that would allow portions of Medicaid to be funded in a block grant. This would cap the amount of Medicaid spending but completely change the way Medicaid is funded today. This month CMS announced that the proposal is still under consideration and is a "high priority" but has been delayed due to COVID-19. A timeline for the review was not provided.

Texas Medicaid Updates

With COVID-19 cases continuing to increase creating an unprecedented amount of people losing jobs the uninsured rate is seeing its highest percentage in years. Since May Texas uninsured rate rose to 29% making it the highest of all 50 states including District of Columbia.

On Sept 28, 2020, the Texas Health and Human Services Commission (HHSC) issued a request for information to solicit feedback regarding the use of Medicaid managed care organizations (MCOs) to provide women’s health and family planning services to the Healthy Texas Women program in one or more health care service regions across Texas.

Utah Medicaid Updates

A new COVID-19 uninsured test coverage is effective beginning June 1. The new program is designed for patients who do not qualify for regular Medicaid. It is retroactive, but does not cover inpatient stays. Patients must not be eligible for HPE, be a US citizen, Utah resident and have no health insurance.

Virginia Medicaid Updates

Since January 2019, 452,000 people have gained coverage due to Medicaid expansion. More than 100,000 recipients enrolled since March due to COVID-19.

*This article was published October 28, 2020.