A few things to know about the end of Medicaid’s continuous coverage requirement

Medicaid's Continuous Coverage policy has been in place for many years and has allowed individuals to maintain their Medicaid eligibility regardless of changes in income or other factors.?However, the policy is now ending and this change could have a significant impact on those who rely on Medicaid for health care coverage.?The Medicaid program ending its continuous coverage policies, also means that hospitals and providers are facing a new reality.

Why Medicaid's Continuous Coverage is Ending?

In exchange for increased federal funding, Congress passed the Families First Coronavirus Response Act (FFCRA) at the start of the pandemic, which included a requirement that Medicaid programs keep people continuously enrolled until the end of the month in which the COVID-19 public health emergency (PHE) ends. ?Medicaid enrollment has increased significantly since the pandemic, owing mostly to the continuous enrollment provision, and the uninsured rate has decreased. ?However, when the continuous enrollment option expires, millions of Americans may lose coverage, potentially reversing recent gains in coverage.

The continuous enrollment provision was terminated on March 31, 2023, and the enhanced federal Medicaid matching funds were phased out until December 2023 as part of a spending plan that was signed into law on December 29, 2022. ?States that accept the increased federal funds are able to resume dis-enrollments in April, but they must adhere to specific reporting and other conditions throughout the unwinding process.

The Impact of Ending Continuous Coverage on Hospitals and Healthcare Professionals.

This change in policy has had significant implications for both hospitals and healthcare professionals. ?Hospitals are now forced to make difficult decisions about the services they can offer, while healthcare professionals must find new ways to provide quality care without the financial security that comes with continuous coverage plans. ?In addition, ending continuous coverage could have a negative effect on patient satisfaction as well as provider morale.

While the end of Medicaid’s continuous coverage is not expected to have an immediate impact on hospitals, it will have a lasting one. ?An absolute total of 8 million individuals are anticipated to lose their coverage, and some may choose not to reapply even if they are eligible for Medicaid.

How States Can Prepare for the End of Continuous Coverage

Before submitting a renewal form or asking for evidence from an enrollee, states must attempt to complete administrative (or "ex parte") renewals by validating ongoing eligibility through available data sources, such as state pay databases. ?Some states delayed renewals while implementing the continuous enrollment provision and making other COVID-related operational changes. ?Renewals that are completed by reviewing electronic data sources to verify ongoing eligibility lessen the load on subscribers to keep coverage. ?However, in many states, the percentage of renewals conducted ex parte is minimal.

States can benefit from steps potential partners are already taking or want to take in order to get ready for the unwind. ?According to a survey of health centers done in late 2021, almost 50% of those that responded said they had already reached out to Medicaid patients to remind them to renew their coverage and set up appointments to help them do so. ?In a similar vein, a recent survey of Marketplace assister programs revealed that these programs were preparing a range of outreach initiatives, including public education events and targeted outreach in low-income communities, to inform consumers about the termination of the continuous enrollment provision.

Conclusion

These are just a few of the potential problems that hospitals and healthcare providers will face as the Medicaid program transitions to managed care. ?We hope this article has helped you understand what those concerns are, why you should be concerned about them, and how hospitals can prepare for when the time comes.

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Danielle Ezra

Executive - Social Media Marketing

V-Etico Services LLC

www.v-etico.com

Phone: 1 (307) 368-8003

E-Mail: [email protected]

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