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Medicaid Disenrollment Begins April 1st

Here's what you need to know

February 2023

The continuous Medicaid enrollment condition of the Families First Coronavirus Response Act will end on March 31. During the continuous enrollment period, patients did not need to be recertified with Medicaid each year. Starting April 1, the unwinding process will begin and the first set of disenrolled patients will start in June. This means there will be an influx of patients coming to your facility that used to have coverage and no longer will.

This unwinding process will affect all categories of Medicaid eligibility patients (minor, parents/caretakers, aged/blind/disabled, LTC, etc.) who are required to recertify every year.

As a result, providers will need to respond to this change as swiftly as possible to ensure that their patients are reenrolled for vital state and federal assistance. With the disenrolling period starting in less than two months, providers should already have begun the process of contacting those patients who will need to be reenrolled.

In addition, providers can expect a significant increase in patients with inactive coverage showing up for services. Providers need to assist patients in the reenrollment process. Here are a couple of vital functions that providers must undertake during this process:

  • Utilize their financial assistance/Medicaid office to work with patients in helping them understand the disenrollment notifications that they receive in the mail.
  • Help patients with recurring services (e.g., chemotherapy, dialysis) apply for other programs.
  • Understand the patient appeal process for continuing coverage. If patients appeal their status, they can request continued coverage until a final determination is made by the relevant authority, so as not to interfere with ongoing services.
  • Assist patients during the Unwinding Special Enrollment Period for the health insurance marketplace.

Remember, redetermination notices will be distributed throughout the year, so this disenrollment process for patients will last at least 12 months.

The disenrollment process will create a lot of changes for providers and their patients. For additional questions or for more information, please contact Adam Abramowitz at [email protected] or 609-220-5627.

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