According to a letter from the agency to Texas Deputy State Medicaid Director Emily Zalkovsky, in January, around 40% of Medicaid applications in the state were processed outside the required 45-day window. The letter was published by U.S. Rep. Lloyd Doggett on June 10.
CMS regulations require states to process Medicaid applications within 45 days. In the letter, Sarah deLone, director of the Children and Adults Health Programs Group at CMS, wrote that the agency has been working with Texas since late 2022 to improve application processing times.
“CMS is concerned that the state’s current efforts are not sufficient to achieve and sustain compliance with federal timeliness requirements for applicants, particularly given the prolonged period of the state’s noncompliance,” Ms. deLone wrote.
The agency asked the Texas Health and Human Services Commission to submit application data, its current staffing plan and other data within 30 days, or face corrective action.
In a statement shared with Becker’s, a spokesperson for the commission said it is “taking all possible actions” to ensure benefit applications are processed quickly.
“HHSC meets with CMS on a regular basis and we will continue to discuss strategies to best serve our clients,” the spokesperson said. “HHSC is also working with our federal partners to implement immediate strategies to reduce the number of SNAP and Medicaid applications in the queue and ensure that the redetermination process operates as smoothly as possible. HHSC reports on application timeliness to CMS monthly.”
The commission has taken dozens of actions to try to speed up application processing, the spokesperson said, including adopting CMS waivers to extend renewals for older adults and adults with disabilities, and retaining temporary staff hired to help process Medicaid renewals.
In a letter to CMS shared with Becker’s, Ms. Zalkovsky wrote that the state experienced a “large volume” of renewal and eligibility applications to process when continuous enrollment requirements in place during the COVID-19 pandemic expired in early 2023.
In April 2023, states began redetermining the eligibility of all Medicaid beneficiaries for the first time since 2020.
“Texas experienced severe operational and systems challenges in the timely completion of these eligibility and enrollment actions in large part due to an unprecedented caseload of renewals that the state was required to process, coupled with significant staffing challenges,” Ms. Zalkovsky wrote.
As of June 4, 2.1 million Texans have been disenrolled from Medicaid through the redetermination process, the most of any state, according to KFF. Another 2.3 million Texas beneficiaries have had their coverage renewed.
