CMS guidance requires states to initiate Medicaid Unwinding between February 1 and April 2023
CMS stresses the importance of accurate contact information for enrollees to ensure eligible people remain covered
With redetermination of Medicaid beneficiaries ramping up nationwide between now and April, the Centers for Medicare & Medicaid Services (CMS) issued additional implementation guidance on January 27, 2023, in a letter to State Health Officials. The Guidance gives clear direction that includes the following:
- States must initiate the redetermination process between February 1 and April 2023.
- Coverage for beneficiaries found ineligible cannot be terminated sooner than April 1, 2023.
- States have 12 months to initiate and 14 months to complete renewal for all individuals enrolled in Medicaid.
- Consistent with the Consolidated Appropriations Act 2023 (CAA) requirements, the Guidance also emphasizes the critical importance of accurate and up-to-date contact information for consumers before and during the unwinding period to help ensure that eligible people remain covered.
Maintaining current and accurate consumer contact information has long-challenged state Medicaid agencies. Often, large quantities of undelivered mail delay eligibility recertification and increase agency administrative costs. To comply with federal requirements, qualify for the enhanced federal financial match for the period April 2023 through December 2023 available through the CAA, and avoid federal penalties for non-compliance, states must act now to put in place two specific processes.
First, before initiating an individual’s recertification, agencies must attempt to update the individual’s address using reliable sources such as the United States Postal Services Notice of Change in Address database, information from the health and human services agencies, or other reliable sources.
Second, agencies must have in place a process to handle recertification forms returned as undeliverable with or without a forwarding address. Starting with and continuing through the state’s Medicaid Unwind period, the agency must attempt to contact the individual whose mail has been returned using at least one other modality (i.e., telephone, email) before terminating Medicaid coverage. For many agencies, this is a new process for which the agency does not have available staff, especially in light of reported workforce vacancies at Medicaid agencies.
Working with government agencies for nearly 50 years, Maximus understands the challenge of collecting and keeping consumer contact information up to date. Using advanced technologies, expertise working with reliable third-party address verification sources, and experienced staff, Maximus can assist states in meeting the CAA requirements. We offer a wide range of services that help states meet CMS requirements to collect and maintain updated contact information, identify alternative contact information, handle returned mail, conduct multilingual outreach to consumers, and establish omnichannel contact centers. In partnership with state agencies, Maximus can ensure compliance with federal Unwind requirements, enhance longer-term efficiencies, and improve communication with Medicaid members.