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Medicare Blog | Medicare News | Medicare Information

10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision

Posted by www.psmbrokerage.com Admin on Thu, Nov 02, 2023 @ 11:11 AM

10 things to know

At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage.

As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the continuous enrollment provision, and phases down the enhanced federal Medicaid matching funds through December 2023. States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process.

This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as recent legislation and guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the continuous enrollment provision.

Read the brief



Tags: Medicare Advantage, Medicare-Medicaid, Special Needs Plans

Medicaid Redetermination - Assisting Members impacted by loss of Medicaid Status

Posted by www.psmbrokerage.com Admin on Fri, Mar 17, 2023 @ 03:28 PM


What you should know

  • Annual Medicaid redetermination was paused during the Public Health Emergency (PHE)
  • February 1, states can begin their Medicaid Redetermination Process, with the potential for Medicaid disenrollment to start April 1, 2023
  • Each state determines when their redetermination process will begin
  • Impacted beneficiaries will be notified by the state approximately 60 calendar days prior to their disenrollment effective date from State Medicaid

What this means for you

  • You can prepare for Dual Eligible Members to complete the redetermination process for continued Medicaid Coverage 
  • Dual Eligible Special Needs Plan (DSNP) members, who are found to be ineligible for Medicaid coverage, will need Agent assistance to obtain new coverage and maintain continuity of care
  • Non DSNP members, whose eligibility level changes, may also require a plan review to ensure they’re still on the plan best suited for them

Please remind impacted DSNP members of the following:

  • Confirm contact information is up to date with the state
  • Watch for mail from the state requesting additional documentation
  • Respond to any request from the state promptly and within deadlines


  Important Resource: Medicaid Redetermination Resource Document

Related Article: https://www.psmbrokerage.com/blog/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-provision 



Tags: Medicare Advantage, Medicare-Medicaid, Special Needs Plans

Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs

Posted by www.psmbrokerage.com Admin on Fri, May 13, 2022 @ 12:06 PM

Tags: Medicare Advantage, Medicare, Part D, New Med Advantage Rules, Special Needs Plans

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