Don’t Ignore Your Mail – Unwinding of Medicaid Continuous Coverage Requirement Starts  April 1, 2023

by: Begley Law Group

Medicaid News:

The Public Health Emergency (PHE) declaration that was put in place by the federal government in March 2020  in response to the Covid-19 pandemic established special rules for states regarding Medicaid benefits.  During the PHE, states were able to use additional money from the federal government for health care programs like Medicaid if they kept people covered.  Although the states may have continued to send annual renewal paperwork to Medicaid beneficiaries, those beneficiaries generally did not lose their Medicaid coverage even if they failed to complete the paperwork or became ineligible for financial reasons.

The passage of a recent federal law ends the continuous coverage requirement on March 31, 2023.  Starting April 1, 2023, New Jersey, Pennsylvania and other states will have to start completing disenrollments if Medicaid beneficiaries are ineligible at the time of their renewal or if they do not complete their renewal.

In New Jersey and Pennsylvania, the “unwinding” process will involve the mailing of renewal packets to all individuals enrolled in NJ FamilyCare/Medicaid program, including MLTSS, or Pennsylvania Medical Assistance.  DO NOT IGNORE THEM –Members will have to provide or confirm information so the states can decide if the members still qualify for benefits.  Members who do not respond to the renewal packets will lose their coverage.

The States have helpful information about the unwinding process and the renewal packets which can be found online:

For NJ: https://nj.gov/humanservices/dmahs/staycoverednj/documents/Member_FAQ.pdf

For PA: https://www.dhs.pa.gov/PHE/Pages/PHE-FAQs.aspx