CMS to states: Slow down Medicaid redeterminations

CMS officials are urging states to double-down on efforts to prevent people from unnecessarily losing Medicaid coverage. 

"I, and everyone at CMS, are deeply concerned about eligible people losing healthcare coverage during the renewal process," CMS Administrator Chiquita Brooks-LaSure told reporters on a June 13 call. 

During the COVID-19 pandemic, states were required to keep Medicaid recipients continuously enrolled in the program. States are beginning the process of redetermining if Medicaid beneficiaries are eligible for the program for the first time since 2020.

Early data from the continuous coverage unwinding shows many people disenrolled from the program were removed because they did not complete the renewal process, state agencies could not find their current address, or other procedural reasons, rather than being deemed no longer eligible for Medicaid. 

At least 1 million people have lost Medicaid coverage as of June 12, according to KFF. 

Daniel Tsai, deputy CMS administrator and director of the Center for Medicaid and CHIP Services, said states should take the full 12 months allotted by the federal government to complete the renewal process. 

In Arkansas, officials are planning to complete the redetermination process in six months, the shortest timeline of any state. Over 80 percent of people removed from Medicaid rolls in the state were because of procedural reasons, according to KFF. 

"We are asking states to do everything in their power to keep eligible people covered," Mr. Tsai said. "It's not enough to just follow the minimum federal requirements. We need states to do more.

On June 12, CMS said it would implement additional flexibilities for states, including: 

  • Allowing managed care plans to complete certain parts of renewal forms on beneficiaries' behalf
  • Allowing states to delay Medicaid termination for one month to conduct more targeted outreach to individuals
  • Allowing pharmacies and community-based organizations to reinstate coverage for some individuals disenrolled for procedural reasons. 

"We are giving our states the tools to keep people covered, and we are calling on our governors to use them," Ms. Brooks-LaSure said. 

In seven states — Kansas, Indiana, Connecticut, West Virginia, Florida, Arkansas and New Hampshire — at least 80 percent of those disenrolled from Medicaid were due to procedural reasons, according to KFF.

Mr. Tsai told reporters the agency's concerns with coverage losses are "across the board." 

"Anytime we see substantial levels of procedural terminations … that creates cause for concerns that eligible people, including kids and families, are losing coverage," Mr. Tsai said. 

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