Payers

New York’s Medicaid leader touts redetermination progress after CMS halts process in other states due to errors

The state is evaluating whether 9 million individuals qualify for various public health insurance programs.
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New York’s Medicaid leader said Thursday that he’s “cautiously optimistic” about his state’s progress in reassessing eligibility for the public health insurance program following the end of Covid-era coverage requirements this spring—despite Centers for Medicare and Medicaid Services (CMS) ordering some states to put redeterminations on hold this week.

New York Medicaid Director Amir Bassiri told United Hospital Fund 2023 Medicaid Conference attendees that the state is in the midst of evaluating whether 9 million people qualify for various public health insurance programs across three eligibility systems. Medicaid enrollment ballooned in New York and across the US during the pandemic, as federal rules prevented states from removing individuals from the program.

“We’re cautiously optimistic, but there’s significant work that needs to be done,” Bassiri said. “[We] will not rest until we get through this process and ensure that everyone who is eligible retains coverage.”

New York plans to use all 14 months of the Medicaid redetermination period to sort through enrollee eligibility. The state processed its first renewal cohort, which had coverage end dates of June 30, Bassiri said. As of that date, almost three-quarters (72%) of renewals for the cohort had been completed through New York State of Health—the state’s health insurance marketplace—and local social services departments.

Bassiri said he’s “not satisfied” with that rate, but noted it could improve since people in the first cohort have until the end of July to renew coverage.

Still, he said, New York is “doing much better than many other states”—something which became apparent after CMS recently directed some states to halt procedural disenrollments.

CMS officials told reporters in a Wednesday call that the agency ordered about a half-dozen states to halt the procedural terminations and re-enroll residents who lost coverage due to errors or lack of due process, Becker’s reported. The agency did not identify the states where redeterminations were paused.

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A CMS spokesperson told Healthcare Brew that the Biden administration “is doing everything in its power to keep Americans enrolled in comprehensive healthcare coverage.” That includes requiring states “to pause terminations, reinstate coverage, adopt strategies to support individuals through the renewal process and address systems issues” or risk losing enhanced federal funding.

CMS has worked with 12 states to halt terminations and address compliance issues, and is in talks with others to ensure they aren’t violating federal rules, the spokesperson noted. Ten states opted to delay procedural terminations for at least a month amid outreach efforts.

As of April 1, states were allowed to begin ending Medicaid coverage for individuals who were no longer eligible—something the federal government had barred since March 2020 due to the Covid-19 pandemic. KFF estimated that as many as 14 million people could lose Medicaid coverage through the process.

Bassiri attributed New York’s relative success to its efforts to make it easy to keep current people covered and reduce churn—i.e., when those who are eligible for Medicaid or another public health insurance program lose coverage for procedural reasons.

“We are doing everything in our power to prevent those types of disenrollments,” he said. “The data that has been shared from other states is pretty concerning: 3 million people across the country have lost coverage. We are not even halfway through this process, so it is incredibly important and we need the support of all your organizations—all of our partners—this is all hands on deck to ensure that we’re successful.”

Navigate the healthcare industry

Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.

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