On October 26, 2022, the Centers for Medicare & Medicaid Services (CMS) held its sixth monthly webinar in preparation for the public health emergency (PHE) unwinding of COVID–19–related flexibilities. CMS will post a recording and transcript of the webinar to the CMS National Stakeholder Calls webpage. Additional resources on unwinding the PHE can be found here for states and providers and here for Medicaid and Children’s Health Insurance Program (CHIP) enrollees. The next webinar will be held on December 7, 2022, at 12:00pm EST.
In March 2020, federal legislation established the “continuous enrollment condition,” which provided states with extra federal Medicaid funding in exchange for maintaining enrollments for all individuals through the end of the month the federal PHE ends. Many states implemented comparable policies that had a similar impact on CHIP. When the PHE ends, twenty million or more enrollees could lose their Medicaid or CHIP coverage. The Department of Health and Human Services (HHS) intends to give at least 60–days’ notice prior to the end of the PHE. When the PHE ends, states will have 12 months to initiate renewals. The PHE was most recently renewed on October 13, 2022, and is slated to end on January 11, 2023.
Speakers discussed information for consumers transitioning from Medicaid to Medicare, state strategies for engaging with local partners on the unwinding, and partner outreach tactics. Stefanie Costello (Office of Communications, CMS), led the call, with remarks from Kim Glaun (Medicare–Medicaid Coordination Office, CMS), Kristen Challacombe (Deputy Director, Arizona Health Care Cost Containment System), Heidi Capriotti (Public Information Office, Arizona Health Care Cost Containment System), and Marcus Johnson (Director of State Health Policy and Advocacy, Vitalyst Health Foundation).
Kim Glaun discussed information for beneficiaries who may be transitioning from Medicaid to Medicare as the PHE ends, including issues impacting dually eligible individuals, the Medicare Special Enrollment Period (SEP), and requirements for renewals. Glaun noted that individuals who maintained Medicaid coverage due to the continuous enrollment requirement during the PHE may not have enrolled in Medicare during their initial enrollment period (the seven–month period starting three months before their Medicare eligibility). CMS is proposing a Medicare SEP for individuals who lose Medicaid after normal operations resume following the end of the PHE or who did not sign up for Medicare on time to address the potential loss of coverage for current Medicaid beneficiaries. Additionally, Glaun highlighted actions states are required to take for Medicaid renewals, including attempting to renew beneficiaries on an ex parte basis, and sending the beneficiary a contact form if the agency is unable to renew the beneficiary without updated information.
Speakers from the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s State Medicaid Agency, discussed Arizona unwinding stakeholder engagement strategies. AHCCCS is the largest insurer in Arizona and is taking a hybrid approach to process member renewals. Strategies AHCCCS is using include processing ineligible beneficiaries before non–responsive beneficiaries and aligning household renewal dates. Additionally, AHCCCS is relying on community partners, including managed care organizations (MCOs), health plan associations, hospitals, committees and councils, and tribes to expand renewal outreach. AHCCCS is also sharing data with MCOs so they can directly conduct outreach to their members to obtain updated beneficiary information and initiate renewals.
AHCCCS has developed tools in additional languages, PHE toolkits and FAQs, and one–page fliers to disseminate information through its partners. Direct member outreach efforts include text message campaigns, robocall campaigns, letter campaigns, and a call center. When 60–days’ notice of the end of the PHE is initiated, AHCCCS plans to further expand its communication efforts through a public awareness campaign on the availability of health insurance.
Marcus Johnson of Vitalyst Health Foundation, a public charity that serves Arizona and provides advocacy support, discussed equitable approaches to outreach. Johnson emphasized the need to reach geographic areas with the highest numbers of beneficiaries at risk for loss of coverage. Like AHCCCS, Vitalyst Health Foundation is collaborating with traditional and non–traditional stakeholders to expand outreach, including MCOs, marketplace issuers, county health departments, trade associations, Arizona Academy of Pediatrics, libraries, small businesses, food banks, daycare centers, and more. Communication strategies include direct–to–consumer messaging and media opportunities, such as op–eds in local papers, digital ads, and press conferences.
The call closed with a brief question and answer session. CMS speakers noted that there is no retroactive termination or recoupments for Medicaid beneficiaries. More information on the Medicare SEP will be forthcoming as the PHE unwinds.
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This Applied Policy® Summary was prepared by Emma Hammer with support from the Applied Policy team of health policy experts. If you have any questions or need more information, please contact her at ehammer@appliedpolicy.com or at 202–558–5272.