Medicaid MCOs Brace for Return of Churn, Other Challenges

As a condition of receiving enhanced federal funds during the COVID-19 public health emergency (PHE), states were required to take certain steps to ensure continuous Medicaid and CHIP coverage for most enrollees, leading to a nearly 18% jump in Medicaid enrollment. But with the latest PHE extension set to expire on Jan. 16, states will no longer receive such funds and will therefore no longer be required to maintain continuous coverage, although CMS has given them 12 months after the month in which the PHE ends to complete eligibility redeterminations. As a result, supporting states’ reverification efforts and ensuring that eligible members stay on the rolls or have a viable landing spot will be critical to Medicaid managed care organizations this year, industry experts tell AIS Health, a division of MMIT.

© 2022 MMIT

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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