The heavily burdened public health system is likely to have a fresh breath of air soon with the roll-out of the novel coronavirus vaccine, which could be the beginning of the end of the public health emergency. The CMS has outlined the states’ priority to Medicaid eligibility and enrollment process that has been hit badly in the pandemic. The four focus areas for Medicaid are: applications, verifications, redeterminations, and renewals.
- According to a Kaiser Family Foundation brief, CMS has suggested that states will have to complete certain Medicaid eligibility and enrollment processes after the public emergency ends. During the pandemic, CMS established waivers meant to streamline administrative processes while states were addressing urgent coronavirus-related demands.
- The four key areas related to the eligibility and enrollment process that states will have to focus on include: applications, verifications, redeterminations, and renewals. This means the states must handle fresh Medicaid applications on a priority basis.
- To clear the backlog, the address verification, including processing pending post-enrollment verifications, and self-attestation should also start during the public health emergency. After the public health emergency, states have six months to complete the pending verifications. This process should be the states’ second priority, along with fulfilling redeterminations and renewals.
- Third area to be addressed is the redeterminations process under which individuals who qualified for Medicaid coverage during the crisis may no longer be eligible after the public health emergency ends.
- Addressing renewals should be the fourth priority. If possible, Medicaid programs should start processing renewals during the public health emergency. However, as with redeterminations and verifications, they have six months after the health emergency to conduct the process.
- In order to streamline the process, CMS suggested prioritizing applications by population, time since the application has been pending, or a hybrid of these two models. Alternatively, states can create their own strategies to sift through applications that are most likely to be ineligible.