• Home
  • About
  • Resources for States
    • Issue Briefs
    • Templates & Toolkits
    • Webinars
  • Expert Perspectives
  • Contact
  • COVID-19
  • Health Equity
  • Unwinding Resources
  • States of Unwinding

Unwinding Resources for States

SHVS Resources and Tools Related to the Unwinding

  • Search

  • Topic:

  • Resource Type

  • Source

State Health and Value Strategies (SHVS) developed this resource page to serve as an accessible one-stop source of information for states in “unwinding” the Medicaid continuous coverage requirement. The Families First Coronavirus Response Act (FFCRA) Medicaid continuous coverage requirement allowed people to retain Medicaid coverage and get needed care during the pandemic. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (CAA), an omnibus funding package that decoupled the continuous coverage provision from the end of the COVID-19 public health emergency by providing a fixed end date of March 31, 2023. These resources are designed to support states during this major coverage event, including developing processes that prioritize coverage retention. SHVS will update this page frequently with new resources as they become available. For more information about how states are unwinding the continuous coverage requirement, SHVS is highlighting examples of the work states are engaging in to prepare for and operationalize unwinding in our series States of Unwinding.

State Health and Value Strategies (SHVS) developed this resource page to serve as an accessible one-stop source of information for states in “unwinding” the Medicaid continuous coverage requirement. The Families First Coronavirus Response Act (FFCRA) Medicaid continuous coverage requirement allowed people to retain Medicaid coverage and get needed care during the pandemic. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (CAA), an omnibus funding package that decoupled the continuous coverage provision from the end of the COVID-19 public health emergency by providing a fixed end date of March 31, 2023. These resources are designed to support states during this major coverage event, including developing processes that prioritize coverage retention. SHVS will update this page frequently with new resources as they become available. For more information about how states are unwinding the continuous coverage requirement, SHVS is highlighting examples of the work states are engaging in to prepare for and operationalize unwinding in our series States of Unwinding.

Filter By:

  • Search

  • Topic:

  • Resource Type

  • Source

PHE Unwinding

Why Millions of Americans May Lose Their Health Insurance

Host Heather Howard, a professor at Princeton University and former New Jersey Commissioner of Health and Senior Services, discusses the unprecedented transition with Kate McEvoy, Executive Director of the National Association of Medicaid Directors, and Dr. Kemi Alli, a pediatrician and Chief Executive Officer of Henry J. Austin Health Center, a federally qualified health center in Trenton, New Jersey. They talk about strategies for maximizing continuity of coverage for consumers — along with who is most likely to slip through the cracks, the role of state health officials and health care providers, and the potential impact on public health.

Read More
Date Created: May 16, 2023
PHE Unwinding

Michigan Gov. Whitmer Takes Action to Help Michiganders Save Money, Stay Covered During Medicaid Eligibility Redetermination Process

Governor Gretchen Whitmer issued an executive directive instructing all state of Michigan departments to work together to help Michiganders keep Medicaid coverage or find affordable health insurance as Medicaid renewals begin. The executive directive instructs all state departments to assist the Department of Health and Human Services (DHHS) and the Department of Insurance and Financial Services (DIFS), by distributing information to Michiganders regarding the redetermination process and how to renew eligibility, and sharing necessary data to conduct outreach.

Read More
Date Created: May 16, 2023
PHE Unwinding

End of the Medicaid Continuous Enrollment Condition Frequently Asked Questions for State Medicaid and CHIP Agencies

CMS released this frequently asked questions (FAQs) document regarding changes made to the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) by the Consolidated Appropriations Act 2023 (CAA, 2023). Key topics addressed in the FAQs include questions relating to the CAA, 2023 returned mail condition for states claiming the increased FMAP available under the FFCRA, reestablishment of premiums in Medicaid and CHIP, renewal requirements for individuals who receive Social Security Income, and Medicaid and CHIP agency capacity to share beneficiary data with enrolled providers to support renewals.

Read More
Date Created: May 16, 2023
PHE Unwinding

States of Unwinding

State Health and Value Strategies launched a new webpage to host the States of Unwinding series. Here you can find each addition to the series in chronological order and filter by topic. The series, which SHVS will continue to update, highlights examples of the work states are engaging in to prepare for and operationalize the unwinding of the continuous coverage requirement to minimize coverage losses. This series aims to showcase strategies that other states may be interested in adopting and highlight how states are leveraging federal flexibilities.

Read More
Date Created: May 11, 2023
PHE Unwinding

Potential Impact of House Joint Resolution 7 (H.J.Res.7)

CMS has confirmed that the termination of the national emergency does not impact the planned May 11 termination of the public health emergency (PHE), any associated PHE unwinding plans, or any existing 1135 waivers.

Read More
Date Created: Apr 19, 2023
PHE Unwinding

HHS Reminds States of Civil Rights Obligations During Unwinding

On April 4, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a letter reminding states (and other entities subject to federal civil rights laws) of their obligations at the end of the Medicaid continuous coverage requirement with respect to: (1) providing equal access for communities of color and language access for individuals with limited English proficiency (LEP); and (2) ensuring effective communication with individuals with disabilities. The letter also highlights best practices (starting on page 5) to ensure that people of color and individuals with LEP or disabilities are not disenrolled during unwinding as a result of ineffective communications and provides a compendium of resources (starting on page 8) to support state efforts.

Read More
Date Created: Apr 10, 2023
PHE Unwinding

Frequently Asked Questions regarding implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and the Health Insurance Portability and Accountability Act (HIPAA)

Frequently asked questions (FAQs) regarding implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and the Health Insurance Portability and Accountability Act (HIPAA). These FAQs have been prepared jointly by the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury. These FAQs answer questions from stakeholders to help people understand the law and benefit from it, as intended.

Read More
Date Created: Apr 10, 2023
PHE Unwinding

States of Unwinding

In this new expert perspective series, State Health and Value Strategies will highlight examples of the work states are engaging in to prepare for and operationalize the unwinding of the continuous coverage requirement to minimize coverage losses. This new series aims to showcase strategies that other states may be interested in adopting and highlight how states are leveraging federal flexibilities.

Read More
Date Created: Apr 3, 2023
PHE Unwinding

Resources to Support State Implementation of Renewal Mitigation Strategies

This document provides a list of available guidance, tools, and resources that may be helpful to states as implement the CMS approved processes and procedures (mitigation strategies) needed to be considered compliant for the renewal provision of section 5131 of the Consolidated Appropriations Act, 2023. Resources are organized by renewal requirement.

Read More
Date Created: Apr 3, 2023
PHE Unwinding

Ensuring Compliance With Federal Renewal Requirements: State Diagnostic Assessment Tool

The tool aims to help states qualify for the sustained enhanced Federal Medical Assistance Percentage, avoid corrective action imposed by CMS, promote continuity of coverage and care during unwinding, and make long-term improvements to eligibility and enrollment infrastructure.

Read More
Date Created: Mar 21, 2023
PHE Unwinding

New CMS Guidance on Medicaid Continuous Coverage Unwinding Provisions in the Consolidated Appropriations Act, 2023

On Wednesday, February 8, State Health and Value Strategies hosted a webinar during which experts from Manatt Health reviewed CMS’ recently released State Health Official (SHO) letter related to “unwinding” the Medicaid continuous coverage guarantee, based on provisions included in section 5131 of the Consolidated Appropriations Act, 2023 (CAA).The webinar reviewed the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter, and discussed key considerations for state policymakers. As a reminder, SHVS has created a single-stop resource page to support states as they plan for unwinding.

Read More
Date Created: Mar 3, 2023
PHE Unwinding

New CMS Guidance on Unwinding Provisions in the CAA, 2023

On January 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” This SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible.

Read More
Date Created: Mar 3, 2023
PHE Unwinding

Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023

Building on existing CMS guidance, the State Health Official letter details the requirements that states must comply with in order to receive the enhanced federal medical assistance percentage; clarifies expectations for states to comply with the Medicaid, CHIP, and marketplace reporting elements required by the CAA; and reviews implications of the CAA on select COVID-19 public health emergency-related flexibilities and authorities.

Read More
Date Created: Mar 3, 2023
PHE Unwinding

Frequently Asked Questions on Agent/Broker Compensation and Guaranteed Availability of Coverage

CMS posted an FAQ that says issuers that reduce or eliminate agent and broker commissions for enrollments through special enrollment periods (SEPs) are violating the guaranteed issue provisions of the ACA and doing so would constitute a discriminatory marketing practice.

Read More
Date Created: Jun 17, 2022
PHE Unwinding

Prohibition on Differing Commission Structures for the Sale of Qualified Health Plans

The state’s Office of Superintendent of Insurance recently notified its carriers that a broker compensation structure that pays differing commissions for open and special enrollments violates state nondiscrimination provisions and constitutes an unfair or deceptive practice under the state’s unfair trade practices statute.

Read More
Date Created: May 6, 2022
PHE Unwinding

Public Health Emergency (PHE) Unwinding Reporting Requirements: Considerations for States

New state reporting templates and guidance released by the Centers for Medicare & Medicaid Services (CMS) on March 22, 2022, build upon a State Health Official letter released on March 3. The resources specify both the data and the metrics that states will be required to submit to monitor enrollment and renewal efforts as they resume routine Medicaid and CHIP operations following the end of the COVID-19 PHE. This expert perspective summarizes the new reporting requirements and presents a set of considerations for states as they begin implementing new unwinding policies, procedures, and reporting.

Read More
Date Created: Apr 1, 2022
PHE Unwinding

Unwinding and Returning to Regular Operations after COVID-19

The Centers for Medicare & Medicaid Services (CMS) released additional templates and resources to support state reporting around enrollment and renewal efforts when the federal public health emergency (PHE) concludes. The resources include 1) a “Renewal Distribution Report” form in which states will be required to summarize their renewal plans, with a focus on mitigating inappropriate coverage loss during the unwinding period and 2) an “Unwinding Eligibility and Enrollment Data Reporting” Excel workbook and specifications document, which aims to support states in reporting on certain metrics around timely application processing, renewal initiation and completion, reason for termination, and fair hearings. CMS also previewed that states will eventually report on these metrics on a monthly basis.

Read More
Date Created: Mar 31, 2022
PHE Unwinding

Tracking the Data on Medicaid’s Continuous Coverage Unwinding

When the Families First Coronavirus Response Act Medicaid “continuous coverage” requirement is discontinued states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. A lack of publicly available data on Medicaid enrollment, renewal, and disenrollment makes it difficult to understand exactly who is losing Medicaid coverage and for what reasons. Publishing timely data in an easy-to-digest, visually appealing way would help improve the transparency, accountability, and equity of the Medicaid program. This expert perspective lays out a set of priority measures that states can incorporate over time into a data dashboard to track Medicaid enrollment following the end of the continuous coverage requirement. For a detailed discussion of the current status of Medicaid enrollment and retention data collection and best practices when developing a data dashboard to display this type of information, SHVS has published a companion issue brief.

Read More
Date Created: Jan 21, 2022
PHE Unwinding

Tracking Medicaid Coverage Post the Continuous Coverage Requirement: Using Data Dashboards to Monitor Trends

The Families First Coronavirus Response Act (FFCRA) 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. The issue brief lays out a phased set of priority measures and provides a model enrollment and retention dashboard template.

 

Read More
Date Created: Jan 21, 2022
PHE Unwinding

Strategies States and the U.S. Territories Can Adopt to Maintain Coverage of Eligible Individuals as They Return to Normal Operations

On November 24, CMS released a “punch list” of strategies states and the US territories can adopt to maintain coverage of eligible individuals as they return to normal operations after the end of the public health emergency. The strategies are organized around seven topics areas: (1) strengthening renewal processes; (2) updating mailing addresses; (3) improving consumer outreach, communication, and assistance; (4) promoting seamless coverage transitions; (5) improving coverage retention; (6) addressing strains on the eligibility and enrollment workforce; and (7) enhancing oversight of eligibility and enrollment operations. In this resource, CMS also flagged strategies they expect to have the biggest impact on mitigating coverage losses.

Read More
Date Created: Dec 14, 2021
PHE Unwinding

Updated Guidance Related to Planning for the Resumption of Normal State Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health Emergency

Updated Guidance Related to Planning for the Resumption of Normal State Medicaid, CHIP, and BHP Operations Upon Conclusion of the COVID-19 Public Health Emergency

Read More
Date Created: Oct 29, 2021
PHE Unwinding

Planning for the Resumption of Normal State Medicaid, CHIP, and BHP Operations Upon Conclusion of the COVID-19 Public Health Emergency

Guidance on planning for the Resumption of Normal State Medicaid, CHIP, and BHP Operations Upon Conclusion of the COVID-19 Public Health Emergency

Read More
Date Created: Oct 29, 2021
No more results
Privacy Policy
Terms of Use

© 2019 State Health and Value Strategies is a program of the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

Stay in Touch

Subscribe to periodic email updates.