36 states are falling short on Medicaid redetermination compliance, HHS says

HHS is urging states to do more to improve Medicaid call center wait times, rates of procedural terminations and application processing times. 

On Aug. 9, the agency sent letters to Medicaid directors in all 50 states, evaluating states' performance on Medicaid call center wait times and call abandonment rates, rates of procedural terminations, and the average wait time for applications to be approved. 

The agency warned 36 states they were falling short of regulatory requirements in at least one area. Alaska, Florida, New Mexico, Montana and Rhode Island were falling short in all three categories, according to the letters. 

Excessive wait times and procedural terminations indicate "potential non-compliance with federal requirements applicable to eligibility redeterminations under title XIX of the Social Security Act," Anne Marie Costello, deputy director of CMS' Center for Medicaid & CHIP Services, wrote to state Medicaid directors. 

"While CMS recognizes the significant steps that states have taken to prepare for unwinding and [simplifying] renewal processes, we urge you to take further action to reduce the number of terminations for procedural reasons as quickly as possible by adopting strategies to increase ex parte renewal rates, to support enrollees with renewal form submission or completion, and to facilitate reinstatement of eligible individuals disenrolled for procedural reasons quickly," Ms. Costello wrote. 

CMS will continually monitor states' wait times and procedural termination rates, Ms. Costello told state directors. 

CMS required several states to pause procedural terminations to correct errors, officials said on a July 19 press call. The agency would not name the specific states it had taken action against. 

As of Aug. 10, at least 4.3 million people have been disenrolled from Medicaid as part of the redeterminations process, according to KFF. 

Of those disenrolled, 74 percent were removed from Medicaid rolls for procedural reasons, rather than being determined no longer eligible for the program. In seven states, more than 90 percent of disenrollments were for procedural reasons, according to KFF's data. 

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