The Centers for Medicare & Medicaid Services’ decision to order states to halt Medicaid disenrollment and restore coverage for those affected by a glitch in Medicaid auto-renewal processes has helped 500,000 people affected by the unwinding, the Department of Health and Human Services reported last week.
Due to what CMS called “faulty programming” in the way automatic, or ex parte, renewals are done, an individual’s Medicaid or Children’s Health Insurance (CHIP) enrollment could be affected by a family member’s eligibility status. On Aug. 30, CMS sent a letter to state Medicaid directors informing them of the error and instructing them to implement safeguards such as assessing eligibility on an individual basis rather than a family basis. As of Sept. 21, 30 states paused their auto-renewal processes and are working to reinstate coverage for those affected.
“Thanks to swift action by HHS, nearly half a million individuals, including children, will have their coverage reinstated, and many more will be protected going forward.” said Xavier Becerra, HHS secretary, in a statement. “We will continue to work with states for as long as needed to help prevent anyone eligible for Medicaid or CHIP coverage from being disenrolled.”
Two states, Pennsylvania and Nevada, had over 100,000 Medicaid and CHIP enrollees unrightfully disenrolled, according to CMS. Only Maine reported no affected individuals.
Because the problem was caused by Medicaid and CHIP auto-renewal functions, many of those affected were children. Still, many older adults and people with disabilities may have also been victim to the ex parte glitch, according to Damon Terzaghi, Medicaid director of home- and community-based services for the National Association for Home Care & Hospice.
“Some of the people impacted are likely to be older adults and people with disabilities,” Terzaghi said in an email to McKnight’s Home Care Daily Pulse. “My sense is that there may be some impact if an older adult or a person with a disability is in a family with other Medicaid beneficiaries who are determined via other methodologies.”
On Thursday, the Medicaid and CHIP Payment and Access Commission hosted a roundtable discussion, which represented voices from CMS, state Medicaid agencies, policy experts and beneficiary advocates. Among their takeaways, the representatives found that improved access to enrollee data can make ex parte renewals reliable and efficient, rather than dangerous and unwieldy.
