Medicaid redeterminations continue, and one state, Arkansas, has finished the process. States are also seeking new Medicaid contractors and dropping others.
Here are 10 updates on Medicaid Becker's has reported since Sept. 28.
- North Carolina is expanding its Medicaid program to an additional 300,000 people in December, but the state is facing unique enrollment challenges amid Medicaid redeterminations. Now, the state must find newly eligible individuals, including ensuring automatic re-enrollment for eligible individuals who may have lost Medicaid coverage during redeterminations, which started in July in North Carolina.
- Advocates are calling for Florida to pause Medicaid enrollments and reinstate coverage for eligible children, as the state defends itself against a potential class action lawsuit.
- Arkansas has completed its Medicaid unwinding process, one of the first states to do so. CMS allowed states 12 months to complete the unwinding process, but Arkansas planned to redetermine eligibility for its Medicaid recipients in six months, the fastest timeline of any state. According to KFF, the state disenrolled at least 373,900 people from Medicaid coverage and renewed coverage for 252,700 people during the unwinding process.
- In a decade leading the Illinois Association of Medicaid Health Plans, CEO Samantha Olds Frey has worked to build managed care in the state from the ground up, winning "hard-fought" trust from providers. Ms. Olds Frey sat down with Becker's to discuss the current state of Medicaid in Illinois and her hopes for the future.
- Some states are opting for new carriers to administer their Medicaid managed care programs. Here are three states dropping contracts Becker's has reported since July.
- Molina Healthcare will no longer administer Indiana Pathways for Aging, a long-term services Medicaid contract, the company said in regulatory filings. Molina said it was required to have a dual eligible special needs program in place in Indiana by Jan. 1 but was "unable to do so due to an administrative requirement of CMS."
- Alaska will pause procedural Medicaid coverage terminations through October after many children were disenrolled from the program.
- Federal lawmakers are launching an investigation into the largest Medicaid managed care organizations over prior authorization denial rates.
- The shift from Medicaid coverage to individual exchange coverage is not going as planned, according to The Washington Post. Even in states investing in helping people who have lost their coverage find an individual plan, uptake has been slow.
- New Hampshire is looking for payers to administer its Medicaid managed care program starting next year. The state said in early September it expects to select three insurers to administer benefits starting Sept. 1, 2024 through Aug. 31, 2029.