Medicaid, CHIP Enrollment Process Streamlined

The Biden administration has proposed a new rule to overhaul the application and renewal process for Medicaid and other government programs like the Children’s Health Insurance Program (CHIP), CMS announced. By simplifying enrollment and verification processes, CMS is aiming to make it easier for children, older adults, and people with lower income to both attain and retain Medicaid and CHIP coverage.

The federal agency is striving to make it easier for eligible people to enroll in and continue their Medicaid coverage. With the COVID-19 public health emergency slated to end on October 13, the proposed rule comes at a time when states are beginning to notify Medicaid beneficiaries about potentially losing coverage. The proposal includes standardizing eligibility and enrolment policies like limiting renewals to once every 12 months to allow applicants 30 days to respond to information requests.

It would also end lifetime benefit limits in CHIP, allowing children to enroll in coverage immediately by doing away with pre-enrollment waiting periods. Children’s eligibility would transfer directly from Medicaid to CHIP when a family’s income rises, preventing an unnecessary redetermination process.

For adults aged 65 and older, as well as those with a disability, the proposed rule would remove unnecessary administrative hurdles for individuals who are eligible for the government programs.

“This proposed rule will ensure that these individuals and families, often from underserved communities, can access the health care and coverage to which they are entitled – a foundational principle of health equity,” CMS administrator Chiquita Brooks-LaSure said in a statement.

USA Today (8/31, Lee) reports HHS “aims to make enrolling in government health care programs easier for low-income kids,” people with disabilities, “and older adults by cutting red tape, according to a proposal announced Wednesday.” This proposed rule “takes steps to reduce the paperwork burden often associated with health care by streamlining applications and standardizing policies and requirements across states for Medicaid, Basic Health Programs and the Children’s Health Insurance Program, or CHIP.” If implemented, “2.81 million more people are projected to enroll in Medicaid over the next five years,” according to the agency.

Modern Healthcare (8/31, Goldman, Subscription Publication) reports among the policies included are “limiting eligibility checks to once every 12 months, requiring renewal forms to be pre-populated with certain information and establishing consistent processes across states,” as well as “measures to help qualified beneficiaries remain on the programs from year to year.”

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