Following lack of federal PHE-ending notification, HCPF provides updated PHE unwinding plan for Colorado

The Department of Health Care Policy & Financing (HCPF) hosted an informational session Thursday on preparing for the end of the Public Health Emergency (PHE). 

 

 

PHE is scheduled to end on Jan. 11th but since the Biden administration didn’t announce that it would officially be ending by the 60-day mark on November 12th, it is expected to extend the emergency for another 3 months. 

During the virtual session, HCPF officials affirmed that the lack of federal notification implies that the PHE will extend until at least April 2023.

HCPF outlined 3 key operational goals for the unwinding: continuity of member coverage, smooth transitional experience for members, and minimizing the unwinding’s impact to state staff and eligibility workers. 

The department presented an overview of resources and timelines for partners to assist the state’s 1.7 million individuals receiving continuous coverage in preparing for and taking part in the renewal process.

“CMS, our federal partners have also provided states with temporary strategies to be able to go through this big workload and this requirement for us. They’ve provided temporary waivers such as 1902(e)(14)(A) waivers and disaster state plan amendments,” said Marivel Klueckman, Director of Eligibility at HCPF. 

For Colorado, we’ve been looking at all of those and we’ve chosen to ask for a waiver to accept [instances where patients have no] income. If a member or an individual indicates that they’re not working and or they have zero income, and we go to verify with the interface and nothing comes back, at that point, based on this waiver, we’re just going to accept it and then we’ll move on without requesting additional verification. Once we get past unwinding, it would require additional verification.”

The federal government requires states to initiate and complete the renewal process within 14 months once the PHE ends. HCPF estimates up to 350,000 could lose coverage unless their information, including their modified adjusted gross income, is up to date. 

HCPF will make redeterminations for renewal 2 months prior to a case’s expiration. If the case is determined eligible, the renewal will take place automatically without any contact. 

If a case is determined ineligible based on the information on file, a renewal packet and communication will be sent out that requires the individual to sign and update their information. Based on the updated information, those deemed ineligible would lose coverage. Those individuals would be connected to reduced cost plans and other assistance related resources.

Klueckman stressed the importance to its community partners of having members quickly and properly process the renewal packet and keep their information as up-to-date as possible. 

Based on the expected unwinding in April 2023, the first set of coverage discontinuations would occur in May of 2023.