Maryland Medicaid to prioritize certain groups during initial months of PHE unwinding


Nicole Pasia


The Maryland Medicaid Administration under the Department of Health (MDH) provided an update on its preparations for the unwinding of the federal public health emergency (PHE) to members of the Maryland Medicaid Advisory Committee (MMAC) at its June meeting. 

MMAC also discussed recent changes to its 1915(c) waiver reports and upcoming applications. 


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PHE unwinding preparations

Although states have yet to receive a 60-day notice from CMS signifying the end of the PHE, Maryland has worked to develop a plan to return to normal Medicaid eligibility and enrollment operations. For now, MDH is planning to operate under PHE conditions until Sept. 30th, 2022. 

Once the PHE ends, states have 12 months to restore normal operations. During the first 6 months of the unwinding, MDH will prioritize renewals for certain groups. These include those who reported a change in life circumstance and would have lost coverage if not under PHE disenrollment freeze. 

These circumstances include aging out of Medicaid, overscaling the eligible income limit, and receiving temporary coverage. 

“MDH is compiling the data on these groups and once we have the specific numbers we will distribute them over the first 6 months, while processing regularly scheduled monthly renewals,” MDH said in a statement. 

On average, MDH sees a 50% auto-renewal rate for Medicaid enrollees. MDH is also launching an extensive communications and outreach strategy to inform enrollees about renewing coverage. This includes the use of a colored flyer in all manual renewal notices and working with the Maryland Health Benefit Exchange and the Department of Human Services to coordinate messaging on their websites and social media.


Waiver and State Plan Amendment (SPA) updates

MDH also updated MMAC members on its 1915(c) waivers, which provide home and community-based services. MDH is looking to renew 3 waiver programs for an additional 5 years: community supports, family supports, and the Autism waiver. 

The community supports waiver provides services such as day habilitation, respite care, and behavioral health support to individuals over the age of 18 with developmental disabilities. The family supports waiver provides similar services to individuals with developmental disabilities aged 0-21. The Autism waiver provides residential habilitation, adult life planning, and family consultation services for individuals with autism aged 1-21. 

MDH submitted its renewal application to CMS in November of 2021, requesting a renewal from April 22nd, 2022 to June 30, 2026. It received feedback on the waiver application from CMS on June 10th. Responses to CMS feedback for all three waiver programs are due on Sept. 9th and will be subject to final approval. 

MDH also submitted a state plan amendment to CMS on June 13th regarding the expansion of coverage for pregnant enrollees up to 12 months postpartum. Although subject to final CMS approval, the intended start date for this coverage was set to April 1st, 2022.