March 2nd, 2023
Unwinding of Continuous Medicaid Coverage: HHSC will stagger Medicaid Eligibility Determinations, separating into 3 groups. IDD will be in the last group, meaning that packets will be sent in June with persons having 30 days to reply. More information can be found at: https://www.hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information/end-continuous-medicaid-coverage-ambassador-toolkit
February 9th, 2023
The Biden administration plans to end the state of Public Health Emergency (PHE), due to the pandemic. Many are warning that the shift will have major implications for people with disabilities that go far beyond COVID-19.
Under the public health emergency, which has been in place since 2020, states have been eligible for extra federal funding for Medicaid in exchange for agreeing not to drop most beneficiaries from the program. The federal government has also given HCS providers added flexibilities during this time.
Currently, it appears that President Biden plans to extend the public health emergency to May 11, at which point it will end.
Once the PHE is over, it will trigger a widespread effort by Medicaid programs across the country to re-evaluate each beneficiary (in this case, meaning individuals in our IDD programs) to determine whether or not they remain eligible. Many are worried that quite a few persons with developmental disabilities could inadvertently or accidently be dropped from the program, even if they still qualify. In addition, if they lose Medicaid eligibility even temporarily due to this issue, it will make it much harder to reverse the decision in a timely fashion. This would affect providers in receiving funds for their services provided to individuals. It would also mean that these individuals would not be able to obtain HCS services possibly anymore as they would not qualify for the waiver and they would not be able to receive their medical care and medications through Medicaid.
I can’t stress enough, that people with disabilities and their families (or specific Medicaid contact person) make sure they respond to any mail or email from their Medicaid office, that their address is up to date at HHSC & Medicaid as well as being in compliance with the financial eligibility rules under Medicaid as well. Be sure to fill out any annual Medicaid Status Reports on time as well.
If an IDD provider (HCS, TxHmL, etc..) is the contact person for Medicaid please have all available persons that are appropriate assist with this process to ensure your individuals do not lose their Medicaid. ( i.e. case managers/care coordinators, program managers, financial dept. staff, etc.)
States can start the redetermination process as soon as this month and can terminate Medicaid coverage for individuals as early as April 1. Across the country, the process is expected to be complete no later than May 2024.