On March 31, 2023, Medicaid continuous enrollment came to an end along with the temporary provisions of the COVID-19 public health emergency. The policy, introduced by the federal government under The Families First Coronavirus Response Act (FFCRA), had been instrumental in ensuring individuals who qualify for Medicaid could maintain coverage without interruption. Now, states have up to 12 months to return to normal eligibility and enrollment operations.
This policy change is considered the largest health coverage transition event since the first open enrollment period of the Affordable Care Act, and will affect nearly 15 million people. Of these 15 million people, approximately:
As coverage gaps disrupt access to health services and increase the risk of uncompensated care, it is important for all patients and providers to be aware of these changes and understand how they might be affected. For patients, the end of Medicaid continuous enrollment means that they will need to reapply for benefits each year in order to maintain coverage, which can be a confusing and time-consuming process. For healthcare providers who serve Medicaid patients, the end of Medicaid continuous enrollment could create significant financial challenges if they are not reimbursed for the care they provide to patients who have lost their Medicaid coverage.
While patients navigate the complex process of re-enrollment, providers can take steps to proactively identify patients who have lost their coverage and help them reapply for benefits.
Here are two main ways providers can leverage automated revenue cycle software to mitigate the impact of this wind-down:
Providers should use automated processes at every step of the patient journey to not only re-verify Medicaid coverage, but also help locate any active coverage that may have been overlooked. By using maxRTE real-time eligibility verification and insurance discovery, providers can identify patients who have lost their Medicaid coverage and work with them to reapply for benefits. This can help ensure that patients maintain their coverage and can access the care they need, while also helping providers to receive reimbursement for the care they provide, even in the face of changing policies and regulations. Learn more about how maxRTE’s Insurance Discovery software stands above the rest and request a free test file today.