Public Health Emergency Unwind: Medicaid Recertification
April 28th, 2023 | NewsMedicaid, Child Health Plus (CHP), Health and Recovery Plan (HARP), and the Essential Plan (EP) did not have to recertify due to the continuous coverage requirements established under the Families First Coronavirus Response Act that went into effect in March 2020. This is about to change.
Recertification notices are being sent to enrollees starting this spring, which include deadlines for recertification, after which enrollees risk being without coverage. Deadlines are based on enrollment end dates and will range from June 30, 2023, through May 31, 2024. The Centers for Medicare and Medicaid Services (CMS) estimate 17% of enrollees may lose coverage as the products requiring recertification are based on meeting financial hardship requirements.
Area payers with Medicaid plans impacted by the PHE unwind are partnering with providers to ensure that impacted patients are informed of and assisted with the recertification process; read more about those efforts below. AHP encourages practices to contact their provider relations representatives for more information. Additionally, practices are encouraged to use the ePACES system and, for managed Medicaid plans, the applicable payer’s provider portal to check member eligibility before service provision.
With Members
Ensuring patients have health coverage and access to care is MVP Health Care’s® (MVP) top priority. MVP is proactively contacting members to ensure they receive important notifications from NYSOH regarding their recertification. Additionally, MVP is asking members to be sure their mailing address, phone number, email address, and other contact information are up to date with NYS Medicaid and MVP so they receive important notifications. For enrollees no longer financially eligible for Medicaid, CHP, HARP, or EP coverage, MVP offers Individual products through New York State Of Health (NYSOH), and premium assistance through government subsidies may be available. If patients have questions, they can contact the MVP Customer Care Center at the number on the back of their MVP Member ID card.
With Practices and Providers?
MVP would like to:
- Craft a plan with practices to address the health insurance enrollment, education, and advocacy needs of patients and their families.
- Work with practices to deliver MVP Plan Guides, conduct outreach, participate in events, and participate in the recertification and enrollment activities.
Some of these efforts are already underway with some practices. Please contact Melissa Tekle at [email protected] with questions about how MVP can work with your office.
With Members
Patients will receive notifications about their renewal dates and required actions ahead of time – either from the New York State of Health or their Local Department of Social Services. It will be very important that your patients pay close attention to all communications and keep their contact information up to date. The first renewal reminders were sent to individuals beginning in March for coverage ending June 30, 2023.
With Practices and Providers
It is important your office be aware of when your patients’ coverage is ending and when action is required to stay continuously covered. Valuable information can be found in several places, including:
- The Fidelis Care’s Provider Portal (Provider Access Online): Check patient details for their renewal or “recert” date on available member rosters. The dates listed are the 1st date the member is eligible for the recertification process (90 days before the termination date).
- EDI Eligibility Verification Transactions: Coverage end dates are included in standard EDI eligibility verification transactions and are compatible across platforms and clearinghouses.
- Fidelis’ Renewal Webpage: Educational materials for providers and patients are available in languages specific to your patients’ needs.
Fidelis Care also has a dedicated team of staff to assist your patients with renewing their coverage. You can help by sharing the Renewal Reminder Card [insert link] with patients who need to recertify or by filling out the online Renewal Assistance Form if the renewal deadline is within three days.
If you have any questions, please contact your Fidelis Provider Relations Specialist.
With Members
Rolling renewal campaigns began in April, featuring five contact methods to ensure eligible members can retain their health insurance coverage. Direct mail, text notifications, outbound phone calls, email notifications, and a dedicated renewal webpage are in use to contact health plan members.
With Practices and Providers
The dedicated renewal and recertification team at Excellus BCBS has contacted many provider offices to offer on-site enrollment opportunities for patients. If your office would like an Excellus BCBS representative to visit your office, please contact your AHP provider relations representative, Jana Darlington or Renée Sutton.
