The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
Risk Adjustment and Reinsurance: A Work Plan for State Officials Webinar
Wakely Consulting Group – Ross Winkelman, Mary Hegemann and Syed Mehmud
Parallel with the release of the issue brief of the same name, Ross Winkelman and colleagues from Wakely Consulting led a webinar explaining what decisions states need to make over the next two years to ensure a robust risk adjustment and reinsurance program. The slides include color coded timelines for various state scenarios. Data needs and availability were also discussed, along with the role of insurance carriers in the risk adjustment and reinsurance program development process.