Public Health Emergency
The Public Health Emergency (PHE) was renewed again this month to extend through April 16th.
CMS will provide states with a 60-day notice prior to the end of the PHE so they can prepare the wind down back to normal Medicaid operations.
Medicaid State of the Union
Governor Mike Dunleavy is making plans to change the large and growing Department of Health and Social Services. He is preparing an executive order that will separate the current department into two divisions. The Department of Health division will manage public health, behavioral health, healthcare services and senior and disability services. The Department of Family and Community service will include Juvenile justice, office of children services among several other sub-departments. The governor believes separating the departments will allow for better control, management and innovation.
On December 29, 2021 CMS sent a letter to the state approving their request for the 1115 waiver titled California Advancing and Innovating Medi-Cal (CalAIM). The waiver is designed to assist with whole-person care that includes vulnerable populations such as the homeless, those with behavioral health concerns and children with complex medical conditions.
The new program does not change benefits provided by Medi-Cal, but it provides coordinators and technology that will help members with medications, mental health services and apply for community-based services, including housing and food assistance.
To help with the estimated 500K – 530K Medicaid recipients who may need to be renewed when the PHE is over, the state is leveraging telephonic signatures, making many upgrades to their PEAK renewal module, implementing an intelligent character redesign (ICR), enhancing the Health First Colorado App, bringing stakeholders into the loop and implementing upfront income verification.
State Medicaid leadership has finalized a plan for the unwinding of Medicaid after the PHE, but much of it teeters on the outcome of the Build Back Better Bill and the pending state budget requests. Since there are many pending changes, the state is not sharing the plan at this time.
The Agency for Health Care Administration (AHCA) submitted a 36.5-billion-dollar budget request that is now sitting with the House Health Care Appropriations Committee for consideration. Much of that budget proposal is allotted for Medicaid rate adjustments and Medicaid hospital direct provider payment among several other areas in need of funding.
On December 23, 2021, CMS sent a letter to the state advising they are officially withdrawing the approval of the work requirement and premium policy that was originally approved by the Trump administration.
Beginning in 2022, the state has reverted to Kynect and became a state-based health exchange on the insurance marketplace. Originally, the state mirrored the federal government to end the health exchange open enrollment January 15th. However, it was recently announced they would be extending open enrollment to January 31st.
Louisiana Department of health announced that they received approval from CMS to launch the Act 421 Children’s Medicaid Option (TEFRA), Medicaid coverage for children with disabilities. The new program allows certain children regardless of income to receive Medicaid coverage.
New Hampshire is planning for the re-determination of their Medicaid population, but it cannot do so until the Public Health Emergency ends. State officials estimate once the PHE is over there could be around 30,000 people who no longer qualify for Medicaid but have been kept on the program through the pandemic.
The state has published guidance on their website informing recipients on how to renew coverage, make changes to their snap benefit and sign up for text message notifications.