Medicaid and the PHE Expiration

January 1, 2023

The Public Health Emergency (PHE) is issued by the HHS Secretary in 90-day increments. The current Covid-19 PHE has been extended to January 11, 2023, however, due to recent federal legislation, the PHE is expected to officially end in mid-April 2023 with no further extensions.  The resumption of the redeterminations is expected to lead to millions of people in the US losing Medicaid coverage.

Since the start of the Public Health Emergency (PHE) in March 2020, many states, including Arizona, suspended all Medicaid disenrollment (unless a member moved out of state, voluntarily disenrolled, died, or aged out program), per federal requirements.

Once the PHE officially ends, AHCCCS estimates that approximately 500,000 members currently enrolled (Acute and LTC) will need to complete a renewal to determine eligibility. There may be documents that need to be provided and forms that will need to be signed to continue eligibility.  It will be very important that the process is followed, and proper documentation provided. If the requests are not met, the member may be disenrolled.

It is quite possible that many of your residents/members will have questions and concerns about their eligibility.   Is their income still below limits?  Are they over resourced?  If the member comes to you with questions about their redetermination letter, do you have a plan to help them?  To avoid unnecessary denials, make sure the member’s address is correctly reflected at AHCCCS – you don’t want them to miss their redetermination notification.

Start discussing this issue with your residents, provide them with reassurance about the process and offer resources to help them if they have concerns. If they are over their resource limit, best to come up with a plan BEFORE they get their redetermination letters so there is time to complete the necessary Medicaid spend down.

Here is some additional information about Medicare Spend Down Options.

Medicaid Spend Down