Recent Medicaid updates- The Department of Health and Human Services has halted Medicaid enrollments in 30 states due to renewal system issues, with potential complications in continuous coverage during a government shutdown. Adena Regional Medical Center will end its contract with Anthem BCBS’ plans in Ohio. A proposed bill aims to automatically enroll children in Medicaid from birth to age 18. North Carolina’s Medicaid expansion starts on December 1, covering 600,000 residents. Kansas’ Governor is championing Medicaid expansion. Procedural Medicaid terminations in 30 states are paused, restoring coverage for nearly 500,000 wrongly disenrolled individuals.
1. Medicaid Enrollment Paused in 30 States: The Department of Health and Human Services (HHS) has temporarily halted Medicaid enrollments in 30 states due to reported issues with their automatic renewal systems. Additionally, some states are deliberating or implementing Medicaid expansion.
2. Government Shutdown Concerns for Continuous Coverage: The prospect of a government shutdown raises concerns about potential disruptions in the process of unwinding Medicaid continuous coverage requirements.
3. Adena Regional Medical Center Contract Termination: Adena Regional Medical Center is set to terminate its contract with Anthem BCBS’ Medicare Advantage and managed Medicaid plans in Ohio, effective November 2.
4. Medicaid for Every Child Act: Senator Bob Casey, a Democrat from Pennsylvania, introduced the Medicaid for Every Child Act on September 15. This proposed legislation seeks to automatically enroll all children under the age of 18 in Medicaid from birth to age 18, eliminating the need for periodic redetermination.
5. North Carolina’s Medicaid Expansion: North Carolina is poised to launch its Medicaid expansion program on December 1, with expectations of providing coverage to over 600,000 state residents.
6. Kansas Governor’s Push for Medicaid Expansion: Governor Laura Kelly of Kansas has initiated a statewide campaign advocating for Medicaid expansion, highlighting it as a top priority for the upcoming legislative session.
7. Restoration of Improperly Disenrolled Individuals: HHS has suspended procedural Medicaid terminations in 30 states due to automatic renewal system issues. This suspension will lead to the restoration of coverage for nearly 500,000 individuals who were improperly disenrolled due to system errors.
8. CMS Audit of Texas HHS: The Centers for Medicare & Medicaid Services (CMS) is conducting an audit of Texas Health and Human Services (HHS) to ensure compliance with federal requirements during the Medicaid redetermination process. Information on whether other states are also undergoing audits remains undisclosed.
9. Audit Findings in New York: Two audits conducted by the state’s comptroller reveal that New York’s Medicaid program paid $388 million for medical services between 2016 and 2022 that should have been covered by federally-funded plans like Medicare.
10. Medicaid Plan Ratings: Thirteen Medicaid plans in seven states have received 4.5-star ratings from the National Committee for Quality Assurance. Notably, no Medicaid plans achieved a five-star rating. Detailed information on the plans receiving 4.5 and four-star ratings can be found below.
