CMS Extends Regs Allowing Medicaid Plans to Assist Renewals

CMS on May 9 extended through June 2025 waivers meant to help states and Medicaid managed care organizations navigate the unwinding of COVID-19 pandemic-related eligibility rules. The waivers, which include provisions allowing MCOs to reach out to members about redeterminations and help members complete eligibility paperwork, were originally set to expire in January 2025.

The extension of the waivers — specifically, 1902 (e)(14) waivers — could help MCOs leave behind the upheaval caused by the return of eligibility redeterminations, which resumed in spring 2023 after a multiyear pause tied to the COVID-19 public health emergency. The crush load of eligibility checks has been difficult for states to manage. Many states disenrolled eligible Medicaid beneficiaries for administrative reasons, typically because the beneficiary made an error in their eligibility check or didn’t return paperwork in time to meet a redetermination deadline. The chaos, which was the subject of mutual recrimination between states and CMS, has caused no shortage of headaches for MCOs.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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