Wednesday, May 03, 2023
Phase out began April 1 of pandemic-era federal flexibility providing enhanced Medicaid funding
PITTSBURGH (April 20, 2023) - A pandemic-era federal flexibility that allowed states to maintain enrollment of Medicaid beneficiaries regardless of their eligibility status began a year-long phase out on April 1, as the Department of Human Services (DHS) returns to pre-pandemic renewal guidelines for beneficiaries. The return of these pre-pandemic renewal, or redetermination, guidelines will affect millions across the nation. Pennsylvania is working to avoid lapses or disruptions in health coverage as Medicaid recipients complete their regular annual renewal process to determine if they are still eligible.
In support of these efforts, Highmark Wholecare has developed a comprehensive member, provider, and community partner awareness and education campaign to assist these stakeholders with understanding and navigating Pennsylvania's Medicaid renewal process administered by DHS.
The number of Pennsylvanians enrolled in Medicaid and Children's Health Insurance Program (CHIP) increased by nearly 30% from February 2020 through February 2023, according to DHS. Thousands of Highmark Wholecare members will be affected by the phase out of the federal flexibility. Prior to COVID-19, all Medicaid and CHIP enrollees had to complete an annual renewal to assess eligibility and maintain coverage. Pennsylvania's DHS has continued to send renewal paperwork through the pandemic, but households were not disenrolled for not meeting eligibility or failing to complete a renewal packet.
"We are doing everything possible to guide our members, providers, and community partners through this unprecedented health event, and have worked closely with the Department of Human Services to create this detailed campaign," said Joe Glinka, director of HealthChoices, Highmark Wholecare. "It's critical that every member eligible for Medicaid remains in the program and those who no longer qualify transition without a coverage gap to a different health plan through Pennie®, Pennsylvania's health insurance marketplace."
The Kaiser Family Foundation estimates that up to 14 million people nationally will lose Medicaid coverage by March 2024 due to the discontinuation of the federal pandemic flexibility.
The awareness and education campaign for Highmark Wholecare members, providers and community partners includes a how-to-renew video, educational web page, member and provider letters, flyers, digital advertising, event participation and in-person engagement and phone outreach. Many of the materials will be bilingual, including the how-to-renew video, website landing page and flyer. Future member-centric initiatives include text reminders and email outreach.
"In many of our materials, we emphasize and thoroughly explain the simple steps members must take, such as updating their mailing address, to ensure an accurate renewal review by DHS," Glinka added.
The awareness and education campaign will include information on how individuals who no longer qualify for Medicaid can transition to other high-quality plans. Highmark Wholecare is working diligently to ensure that members who fail eligibility for Medicaid are appropriately made aware of alternative health plan markets such as the Children's Health Insurance Program (CHIP) and Pennie® Pennsylvania's official health insurance marketplace. Highmark Wholecare's parent organization, Highmark Health, has a presence in each of these health plan markets.
"Our Living Health model removes barriers to care," Glinka said. "It is our hope that the information in our awareness and education campaign, and our alignment with Highmark Health, will be of material assistance in helping members failing Medicaid eligibility to secure alternative coverage that's best for them."
The Highmark Wholecare awareness and education campaign will run throughout the upcoming federal program phase out and beyond. Renewals will be completed between April 1, 2023 and March 31, 2024.
About Highmark Wholecare
We believe in caring for the whole person in all communities where the need is greatest. We see a future in which everyone has equal opportunity to achieve their best health. Through our leading Medicaid and Medicare programs, we are coordinating health care that goes beyond doctors and medicine that helps members achieve not just physical health, but also delivers whole person care. Our team members are helping to drive this new kind of health care for our 410,000 Medicaid and Medicare members in collaboration with a network of 29,000 primary care physicians, specialists, hospitals, and other ancillary providers. We are also committed to supporting our neighbors through our many community outreach and engagement programs.
About Highmark Health
Highmark Health, a Pittsburgh, PA-based enterprise that employs more than 37,000 people who serve millions of Americans across the country, is the parent company of Highmark Inc., Allegheny Health Network, enGen, and Helion. Highmark Inc. and its subsidiaries and affiliates provide health insurance to approximately 6.8 million members in Pennsylvania, West Virginia, Delaware, and New York, as well as dental insurance, and related health products through a national network of diversified businesses. Allegheny Health Network is an integrated delivery network in western Pennsylvania comprised of 14 hospitals, more than 2,600 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions. enGen is focused on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge, and integrated cloud-based platforms. Helion works with payers to cultivate high-performing networks while empowering providers to operate at their best. To learn more, visit www.highmarkhealth.org.
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