HHS secretary 'deeply concerned' about procedural Medicaid losses

HHS Secretary Xavier Becerra is urging states to do more to prevent people from losing Medicaid coverage for procedural reasons. 

"I am deeply concerned with the number of people unnecessarily losing coverage, especially those who appear to have lost coverage for avoidable reasons that State Medicaid offices have the power to prevent or mitigate," Mr. Becerra wrote in a June 12 letter to governors. 

In a June 12 news release, CMS said the agency will implement additional flexibilities for states to keep more people covered, 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. 

"Given the high number of people losing coverage due to administrative processes, I urge you to review your state's currently elected flexibilities and consider going further to take up existing and new policy options that we have offered to protect eligible individuals and families from procedural termination," Mr. Becerra wrote. 

Some states began terminating coverage for ineligible Medicaid recipients in April after continuous coverage requirements in place during the COVID-19 public health emergency ended. 

In Indiana, Florida and Arkansas, more than 80 percent of disenrollments were because enrollees did not return required paperwork or other procedural reasons, rather than being determined ineligible for the program, according to a May 31 report from KFF. 

In Florida, more than 250,000 people were disenrolled from Medicaid in the first month of redeterminations. Of those disenrolled, 80 percent did not respond to requests to update their contact information. 

In Arkansas, nearly 73,000 people were disenrolled from Medicaid in April, with 75 percent of these disenrollments because individuals did not return requested forms or the state could not locate their current address. 

In his letter to governors, Mr. Becerra also encouraged states to conduct more outreach to parents, whose children may still be eligible for coverage. 

"Any avoidable loss in coverage is concerning, but I am particularly concerned that children may lose coverage because their parents do not understand that even if they experience a transition in coverage, their children are very likely still eligible for coverage through Medicaid or CHIP," Mr. Becerra said. 

Lawmakers also urged CMS to increase its oversight of the Medicaid redeterminations process. 

In a June 8 letter to CMS Administrator Chiquita Brooks-LaSure, Sen. Ron Wyden, chair of the Senate Finance Committee, and Rep. Frank Pallone, ranking member of the House Committee on Energy and Commerce, wrote they are "troubled" by early data on the redeterminations process. 

"The early evidence from many states on redetermination efforts is concerning and suggests that beneficiaries are experiencing red tape, confusion and high rates of procedural terminations," the lawmakers wrote. 

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