As states continue to work through the yearslong backlog of Medicaid eligibility determinations, procedural coverage losses remain a major concern.
The Centers for Medicare & Medicaid Services (CMS) on Thursday issued new, self-reported data from states that offer a look at where they stand with automatic, or ex parte, renewals, which have been circled as a key way to potentially avoid unneeded disenrollments.
In an August letter, CMS urged states to assess their processes and determine whether there is a systems issue preventing them from deploying ex parte renewals at the individual level, per federal rule. Thirty states reported systems issues as of Sept. 21, CMS said.
With those data on hand, CMS barred those states from procedural disenrollments until they could verify that members were removed from the program appropriately, according to an announcement. This will restore coverage to nearly 500,000 people who lose coverage in Medicaid or the Children's Health Insurance Program (CHIP), CMS said.
"Addressing this issue with auto-renewals is a critical step to help eligible people keep their Medicaid and CHIP coverage during the renewals process, especially children," CMS Administrator Chiquita Brooks-LaSure said in the press release. "CMS will keep doing everything in our power to help people have the health coverage they need and deserve.”
The ongoing challenges with ex parte renewals were a key topic of discussion at the Medicaid and CHIP Payment Advisory Commission's meeting this week. Commissioners heard from a panel of experts on where things stand with redetermination.
Dan Tsai, deputy administrator of CMS and director of the Center for Medicaid and CHIP services, said during the session that the sheer scale of the unwinding process is allowing policymakers and other stakeholders an "unprecedented" look at issues within the program, including the challenges around automatic renewals.
"I think that's really, really important," he said.
In addition, Tsai said managed care organizations could be taking on a greater role in facilitating the individual outreach necessary to avoid unneeded lapses in eligibility. Some payers have taken this task on with gusto, he said, while others have been less involved.
"I would like to see plans more consistently using every one of those levers," he said.
Kate McEvoy, executive director of the National Association of Medicaid Directors, said that while plenty of hurdles remain for states as redeterminations roll on, there have been positives that policymakers can take forward.
For one, more people than ever know what Medicaid and CHIP could offer them or their families, and increased "public literacy" for the program is a positive step. She also echoed Tsai in saying that the large volumes of data coming out of redeterminations have enabled greater transparency into the program.