Assisting states in their efforts to transform health and health care
 

Resources for State Officials on Unwinding the Medicaid Continuous Coverage Requirement

A one-stop source of information for states in “unwinding” when the Medicaid continuous coverage requirement ends. This resource page is designed to support states planning for this major coverage event, including developing processes that prioritize coverage retention following the conclusion of the continuous coverage requirement.

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January 14, 2022

New Requirements to Cover Over-the-Counter COVID Tests: Implications for State Insurance Regulators

On January 15, 2022, health insurers will be subject to new federal requirements to cover and waive cost-sharing for over-the-counter diagnostic tests for COVID-19 for the duration of the federal public health emergency. Past federal guidance required insurers to fully cover COVID-19 tests, but allowed them to require enrollees to first obtain a health professional’s determination that a test is medically necessary. The new requirements, published January 10, enable consumers to obtain the tests directly from pharmacies or online retailers without being seen by a health professional. With case rates surging and the costs of over-the-counter COVID-19 tests ranging from $14 to $34, this new benefit should provide significant financial relief to privately insured individuals. This expert perspective focuses on key provisions of the new coverage requirements as well as health equity considerations and implications for state insurance regulators.

Jan 21, 2022 Issue Briefs

The Families First Coronavirus Response Act Medicaid “continuous coverage” requirement has allowed people to retain Medicaid coverage and get needed care during the COVID-19 pandemic. When continuous enrollment is discontinued, states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. The current lack of publicly available and timely Medicaid enrollment, renewal, and disenrollment data will make it difficult to understand exactly who is losing coverage and for what reasons. One effective way to monitor this type of information is through the use of Medicaid enrollment and retention dashboards. This issue brief examines the current status of data collection to assess Medicaid enrollment and retention, summarizes potential forthcoming reporting requirements, and describes some of the best practices states should consider when developing a data dashboard to display this type of information.

 

Dec 21, 2021 Templates & Toolkits

This toolkit provides a communications planning guide and template communications resources designed to support state Medicaid agencies as they prepare for the upcoming end of the continuous coverage requirement. The end of the Medicaid continuous coverage requirement presents states with tremendous opportunities to keep individuals enrolled in health coverage. Developing a communications plan that reflects this goal will be essential to sharing clear, concise, and compelling information with Medicaid/CHIP enrollees and other consumers so that they know the steps they need to take, when to act, and what to do to maintain coverage.