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CMS acts to prevent Medicaid disenrollment

On Behalf of | Jul 25, 2023 | CMS Conditions of Participation, Compliance

Almost 20 million people in Texas and around the country enrolled in Medicaid during the public health emergency that began in January 2020 and lasted until May 2023. These people were able to enroll in the government health care program because Congress put a temporary end to Medicaid eligibility checks when it increased federal funding for the program, but that hiatus came to an end in December 2022 when President Joe Biden signed the Consolidated Appropriations Act into law.

Millions disenrolled

The Consolidated Appropriations Act ended the Medicaid law continuous coverage requirement that had been in place during the public health emergency, and it allowed states to begin redetermining Medicaid eligibility in April. Between April 1 and July 21 more than 3 million Medicare beneficiaries were disenrolled from the program. Most of these Medicaid beneficiaries lost their health coverage for procedural reasons like missing filing deadlines or failing to provide required information in a timely manner. In Texas, about half a million Medicaid beneficiaries were disenrolled.

CMS to impose sanctions

The Centers for Medicare & Medicaid Services has vowed to increase its monitoring of state Medicaid renewal processes to identify problems and prevent Americans from losing access to health care. The agency has already intervened in states that did not implement auto-renewal strategies or failed to send renewal forms to Medicaid beneficiaries. CMS has also announced that states could face financial penalties or lose some of their federal Medicaid funding if program beneficiaries are disenrolled unfairly.

A preventable problem

Medicaid provides access to health care for more than 83 million Americans. Medicare enrollment surged during the Covid-19 state of emergency, but now many people are losing their coverage for procedural reasons. CMS is now taking action to prevent this from happening in the future.