Health officials are focused on ensuring Alaskans retain their health coverage as the state continues its Medicaid redetermination process, and will have extra time to do so.
The federal requirement for continuous coverage for Medicaid recipients ended on March 31st, and Alaska began redetermining the eligibility for the 260,000 individuals enrolled in its Medicaid programs in April. Stakeholders discussed that process at the 2023 Alaska State of Reform Health Policy Conference.
Department of Health (DOH) Deputy Commissioner Emily Ricci said DOH’s Division of Public Assistance is responsible for renewal determinations. The process added to the department’s heavy work backlog, so it requested an additional six months to complete the process, she said. The request was approved by the federal government.
“So instead of completing redeterminations in 12 months, we [asked for] an additional six months,” Ricci said. “That gives us the ability to manage the number of individuals we can initiate the redetermination process for. We did receive approval for that. As the redetermination process progresses, we are making adjustments.”
The department had initiated almost 50,000 renewals by the end of August, Ricci said, which is about 20 percent of the state’s Medicaid population.
Procedural disenrollments occur when recipients do not provide the DOH with information necessary to complete a redetermination. Ricci said the state’s procedural disenrollments increased in August and September.
“A number of states at the national level were seeing the same thing. So (the Centers for Medicare and Medicaid Services) asked states to do testing to identify any errors. As a result, we paused procedural disenrollments for September.”
— Ricci
While procedural disenrollments are paused, the DOH is reviewing any that occurred from June through September to ensure it has the information it needs to redetermine those individuals, and possibly re-enroll them.
“We were hoping that work would be done by the end of October,” Ricci said. “We have a small team so it could take a little longer than that. We’ve found at least 1,500 individuals that we have reinstated. And we anticipate that will increase. This is a large effort. There will be challenges. We’re trying to address them. Our goal is to make sure everyone eligible for Medicaid coverage remains enrolled.”
Jessie Menkens, government and external affairs manager at the Alaska Primary Care Association, said increased provider engagement with Medicaid recipients could improve the process, particularly for those who are unaware of the steps they need to take to retain coverage.
“What happens when folks don’t get their mail?” Menkens asked. “They don’t open their [renewal] packet. The state doesn’t always have a sense of where patients are because they move. A key first step [for providers] would be screening and talking with your patients.”
Gennifer Moreau-Johnson is the senior policy advisor of intergovernmental affairs at the Alaska Native Tribal Health Consortium, which serves more than 180,000 Alaska Native and American Indian individuals in Alaska. She said Alaska Native individuals represent 36 percent of the state’s Medicaid beneficiaries, and the consortium is helping them with renewals.
“We just started receiving names of people up for renewal. We are now on schedule to send out 1,100 mailers because we know who’s up for renewal. Envelopes are arriving, and people may or may not look. We’re sending out postcards to alert people this is important mail coming (their) way. We have sent out 1,500 texts. We are doing outreach. This is going to be critical for rural areas of the state.”
— Moreau-Johnson
Anchorage Neighborhood Health Center CEO Lisa Aquino said about half of the center’s patients are Medicaid members.
“We’re interested to watch as this happens if we see an increase in the percentage of sliding-fee patients (and) people who no longer have insurance,” Aquino said. “And we’re working hard to make sure that doesn’t happen. In many ways, we are the primary care safety net in our community. Redetermination has been a challenge. It’s also been a challenge for our patients. We have a team of outreach and enrollment staff. We’ve been fortunate to increase our capacity to do outreach and enrollment. We’ve increased our staff.”