April 13, 2022: Recently Reuters reported that the COVID-19 PHE has been renewed. The extension allows “millions of Americans to keep getting free tests, vaccines and treatments for at least three more months,” according to the news agency. Reuters also reported that the Department of Health and Human Services (HHS) had said in a statement that it will give states 60 days’ notice prior to termination or expiration.
The extension also means that those who qualified for Medicaid under PHE waiver guidelines can remain on Medicaid. Once PHE is terminated, a number of Medicaid enrollees are at risk of losing coverage.
What is PHE?
In response to President Trump’s proclamation that the COVID-19 outbreak constituted a national emergency (March 13, 2020), the federal government and CMS promptly enacted temporary Public Health Emergency (PHE) legislation aimed at ensuring and expanding access to healthcare. This ruling lifted Medicaid policy and process restrictions to ensure a continuity of care for those citizens whose socioeconomic environment put them at increased health and financial risk during the pandemic. Complementing the decrease in eligibility requirements, elimination of the annual benefit renewal, and removal of cost-sharing, CMS addressed provider dwindling margins by enhancing the federal Medicaid funding match by 6.2%.
How did Medicaid waivers affect the Medicaid program?
CMS’ waivers for existing Medicaid provisions stimulated an unprecedented burgeoning of Medicaid and CHIP enrollment to 85 million people.
What impact does PHE termination have on healthcare providers?
The PHE’s eventual termination will have a major impact on providers requiring them to escalate assistance without the benefit of enhanced funding.
- Address influx of phone calls and ED visits from patients who have lost Medicaid coverage.
- Educate staff, physicians, and patients regarding termination of PHE, its implications, and remedies.
- Increase in self-pay population.
- Augment staff to re-enroll patients in acute, community-based and long-term care Medicaid programs.
What steps can providers take?
- Partner with state, community leaders, consumer groups to assist with the redetermination process.
- Provide education in person, at community sponsored events, on website.
- Assist community leaders, faith-based organizations, etc. by screening patients for Medicaid, assisting with paperwork, answering questions, at events outside of the hospital and on off-hours.
How can Savista Help?
Pre PHE termination:
- Contact Medicaid patients to review their Medicaid status.
- Sign on as Authorized Representative.
- Work with State to identify coverage gaps and provide needed data.
Post PHE termination:
- Offer staff to support patient re-enrollment into Medicaid with Eligibility Enrollment Services.
- Provide patient education.