Thousands of Iowans briefly lost Medicaid coverage over system error, federal officials say
Thousands of eligible Iowans may have been improperly disenrolled from Medicaid and the Children’s Health Insurance Program (CHIP) because of cracks within the ongoing redetermination process, according to federal health officials.
Since April, Iowa has been reviewing the eligibility of Medicaid and CHIP beneficiaries to determine whether they continue to qualify for the safety-net health insurance program under prepandemic qualifications. During the public health emergency, states were barred by federal officials from disenrolling any beneficiary from the program, even if they no longer qualified.
On Thursday, the U.S. Centers for Medicare and Medicaid Services announced it has helped states resume health insurance coverage for Americans inappropriately disenrolled from Medicaid during this redetermination process. This comes after federal health officials sent a letter to all states on Aug. 30 requiring them to determine whether their automatic renewal process for Medicaid determination might have been inadvertently disenrolling residents who still qualified for coverage.
The concern from CMS centers around what is known as an "ex-parte renewal," which entails states using existing data on Medicaid and CHIP beneficiaries to automatically renew their coverage.
Federal health officials say several states were conducting these renewals at a household level, without accounting for the fact that individual members of that household may have a different Medicaid eligibility threshold. As a result, coverage for some eligible individuals — most notably, children who qualify for CHIP — was terminated.
CMS officials said Thursday that Iowa is among 30 states that have not conducted automatic renewals at an individual level or are still working to reinstate affected beneficiaries, according to documents provided to reporters.
Federal officials estimated between 10,000 and 49,999 Iowans were affected by this error as of Sept. 21. State officials are still determining which population was affected by the system error, according to CMS.
Iowa Medicaid officials, however, say the state never received a notice of noncompliance from CMS for its approach to ex-parte renewals, according to a statement from Iowa Health and Human Services to the Des Moines Register.
Still, Iowa officials say the state is working to adjust its approach to automatic renewals when redetermining Iowans' eligibility.
"Changing direction now will be a cumbersome shift for members and eligibility workers alike, and does not consider the ongoing outreach attempts HHS is deploying to reach members," the state agency said in a statement. "These efforts include mail, email, phone, mail, text messages and now, in-person visits to remind some individuals and households to return their renewal forms."
Iowa HHS officials said the state's Medicaid program sent pre-populated renewal forms to all household members if at least one individual in that household could not be determined eligible. If the form was not returned after three outreach attempts by the state, "eligibility is discontinued for all household members who are subject to renewal requirements," state officials said in a statement.
"The Iowa Health and Human Services agency deeply care about the work we do and the Iowans we serve, and we look forward to moving past this recent change so that we can dedicate resources to other areas of the program that impact the health and quality of life for eligible Iowans," according to the statement.
About 900,000 Iowans received Medicaid and CHIP benefits as of April, with more than 168,000 maintained in the Medicaid program under the continuous coverage requirement, state data shows.
As of August, the latest data available, more than 40,500 Iowans have been disenrolled from Medicaid and CHIP since April. That includes individuals determined ineligible for coverage and those terminated for procedural reasons, such as failing to return paperwork.
More than 179,000 Iowans' coverage has been renewed since April, including 97,000 individuals who were renewed on an ex-parte basis.
Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm
This article originally appeared on Des Moines Register: Iowa Medicaid fixing issue that led to thousands losing health coverage
