Medicaid in the headlines: 7 recent updates

As of July 19, more than 3 million people have been disenrolled from Medicaid during the unwinding of the Medicaid continuous enrollment provision, according to KFF. 

CMS has ordered some states to pause procedural terminations of Medicaid coverage to correct errors, and insurers and states are working to shift people to other forms of coverage. 

Here are seven Medicaid updates Becker's has reported since July 7. 

1.  CMS has required around a half-dozen states to pause procedural terminations to correct errors through the Medicaid redetermination process, CMS officials told reporters on a July 19 press call. 
   
   

2. Elevance Health is expecting many consumers who have lost Medicaid to transition to other forms of coverage, executives told investors. According to the company's second-quarter earnings report, Elevance lost 135,000 Medicaid members during the quarter.
   
   

3. HHS' Office of Inspector General raised concerns in an audit about the rate of prior authorization denials in Medicaid managed care and a lack of state oversight of these denials. On average, Medicaid MCOs denied around 1 in 8 prior authorization requests in 2019, according to the audit. Of the 115 MCOs the OIG audited, 12 had prior authorization denial rates greater than 25 percent.
   
   
4. CMS is ramping up efforts to connect over 2 million people who have been disenrolled from Medicaid coverage to ACA plans. "We're in the execution phase to be the appropriate landing spot for many of the folks who are no longer eligible for Medicaid and CHIP," Jeff Grant, deputy director for operations at CMS' Center for Consumer Information and Insurance Oversight, said on a call with stakeholders.
   
   
5. The North Carolina Department of Health and Human Services is again delaying the implementation of its Medicaid managed care behavioral health and intellectual/developmental disabilities tailored plans, this time to an undetermined date.
   
   
6. Nearly 50,000 Medicaid enrollees in Ohio are caught in the middle of a commercial reimbursement fight between Anthem Blue Cross Blue Shield and Cincinnati-based Bon Secours Mercy Health.
   
   
7. Medicaid coverage in Oregon is available to all adults and children who meet eligibility criteria — regardless of immigration status — as of July 1.