CMS reiterates call to action on Medicaid terminations

CMS reiterates call to action on Medicaid terminations

The Centers for Medicare and Medicaid Services remains highly concerned with procedural disenrollments amid large numbers of enrollees losing coverage during the resumption of eligibility checks.

Center for Medicaid and Children’s Health Insurance Program Services Director Dan Tsai hosted a news conference Tuesday to follow a call to action from Health and Human Services Secretary Xavier Becerra on Monday. President Joe Biden’s administration is pushing states to take better care not to remove qualified beneficiaries from the rolls for procedural reasons. HHS expects 15 million people will exit Medicaid by the time the process is complete.

Medicaid redeterminations restarted less than two months after being suspended since 2020 because of the COVID-19 pandemic, and already more than 1 million people have been taken off the program, according to data compiled by the Kaiser Family Foundation. CMS plans to release figures on disenrollments from redeterminations next month, Tsai said.

Becerra wrote governors Monday, pleading with them to utilize flexibilities to facilitate a smooth redeterminations process and to ensure that people whose incomes are still low enough to qualify for Medicaid don’t lose coverage for administrative reasons, such as when state authorities don’t have up-to-date contact information.

“We’re urging and asking every governor and every state to take up every strategy,” Tsai said. CMS specifically touted automatic enrollments for people who are known to be eligible based on their qualification for other government programs such as food assistance, for example.

With CMS’ permission, states also can partner with health insurance companies that administer Medicaid to check enrollee records, issue one-month benefit extensions to people who are disenrolled for procedural reasons to give them time to update their information and work with community-based organizations and pharmacies to help beneficiaries remain enrolled if they qualify, Tsai said. CMS has approved more than 250 waivers from states seeking flexibility as they carry out their legally mandated eligibility checks, he said.

CMS also cautioned states that it will exercise its authority if it determines they aren’t adhering to federal rules meant to protect Medicaid beneficiaries from inappropriately losing benefits. “We will not hesitate to use all of our enforcement tools to ensure that states are doing what they are required to do throughout the renewals process,” Administrator Chiquita Brooks-LaSure said.

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