Medicaid Enrollees Start Receiving Renewal Notifications
As we enter the unwind period and the end of most of the continuous coverage requirements that were in place during the past three years, many clients and residents served by members will be required to have their Medicaid eligibility redetermined. For those who enrolled in Medicaid during the public health emergency (PHE), this may be their first time through the redetermination process.
Beneficiaries with Medicaid enrollment end dates in June are the first to be impacted. While the State is automatically redetermining eligibility in those cases where they can, most individuals will need to take action. Those enrolled in Managed Long Term Care (MLTC) or fee-for-service Medicaid in New York City (NYC) should have received notification letters from the Human Resources Administration (HRA) in March, while those outside of NYC should have gotten, or should be getting, letters from their Local Social Services Districts (LDSSs) in April. Individuals with June end dates who are enrolled in a mainstream Medicaid managed care plan will be getting their letters in May.
This pattern will be repeated for July and each month going forward until everyone is recertified based on the month in which their eligibility is scheduled to end. The State has been discussing this with managed care plans, who are heavily involved in educating their enrollees. While there has been limited outreach from the State to providers so far, the State has developed instructional materials, and Medicaid managed care plans, including MLTC plans, have been working to inform their members and engage partners in educational efforts. Providers should be aware of the timing of the notices and the recertification dates of those who they serve so as to help them to navigate the process as necessary. Resources and the State’s PHE Unwind Communications Tool Kit is available here.
Before the emergency, individuals who reached Medicare eligibility would be disenrolled from mainstream managed care unless the plan offered a Medicare managed care product specifically aligned with their Medicaid offering. However, during the PHE, most mainstream members achieving Medicare eligibility remained in their plan.
During a recent managed care plan meeting, DOH shared that they are implementing a change where members who are 65 and older and/or dually eligible, and who are not in receipt of long term care services, will maintain their Medicaid status in NY State of Health (i.e., no longer transition to the Welfare Management System (WMS)). Any members in these populations who have coverage end dates of June 30th or July 31st will have their renewal process delayed for four months to allow system implementation of this change. After the four-month delay, these members will go through the regular renewal process. Any members who are in receipt of long term care services and are mandatory for MLTC, or that are over the Medicaid income limit, will continue to be referred to the LDSS or HRA.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841