Eligibility Online Manual
M1407 Unwinding Of The Continuous Enrollment in Medicaid and CHIP
Purpose: This section will assist in determining eligibility and processing of renewals during the unwinding of Continuous Enrollment in Medicaid and CHIP.
Current Policy Effective Date: April 1, 2023
Date Last Reviewed: October 7, 2023
Previous Policy:
POL M1407: RENEWAL PROCESSING PROCEDURES DURING THE UNWINDING OF THE CONTINUUS ENROLLMENT IN MEDICAID AND CHIP
1. Benefits May Not Be Closed Or Reduced Until A Renewal Opportunity Is Provided To An Ongoing Client
With CMS' approval, The Agency selected April 1, 2023, as the date to end the Continuous Enrollment Requirement in Medicaid and CHIP.
The Agency opted to hold procedural closures as part of a Mitigation Plan with CMS until August 1, 2023.
2 Effective June 2023, Ongoing EID Clients Will Resume Paying Premiums After His Or Her Renewal, If Determined Eligible
3. New 563B's Are Provided By The DFS Child Support Office And Sanctions Enforced Beginning April 1, 2023, After Renewal is Completed And Adult Is Determined Otherwise Eligible
4. Birth Cost Sanctions Are Being Enforced Once The Client Completes Her Postpartum Period After Renewal Is Completed And She Is Determined Othewise Eligible
5. Resources Are Not Being Considered During Renewal Until April 2024
Resources are considered when switching programs with different resource requirements at the time of the renewal as this is considered a new application.
Notices may be sent as a courtesy to clients who may be over the resource standard for their programs at renewal informing them they would possibly no longer be eligible if resources were being considered.
6. Clients Closed August 1, 2023, For Procedural Reasons Will Be Reprocessed Via Manual Ex Parte And Reopened If Determined Eligible
7. Manual Ex Partes Will Be Conducted For All Clients Prior To Closing For Procedural Reasons Until Individual Ex Parte Is Enabled Systematically In WES
Reference:
Defining Requirement:
42 CFR Parts 410, 411, 414, 417, 433 and 510
The Economic Relief Package Related to COVID-19 (December 2020)
Consolidated Appropriations ACT (CAA) (December 2022) uncoupled Medicaid Enrollment Requirement from the National Public Health Emergency
The National Public Health Emergency Officially ended at the end of business May 11, 2023
Clarifying Information:
Worker Responsibilities:
Documenting Resource Waiver
1. Do not update resources in WES until April 1, 2024.
2. If a client includes resource statements with the renewal or if the client went over the resource limit during the Public Health Emergency, notify the client that resource requirements are being waived until the next renewal is due.
3. Case note WES when the client is over resources.
4. Upload any resource verification provided by the client.
Documenting Resource Waiver
If a client completes a renewal or has a change in circumstances making them eligible for an MSP group (QMB, SLMB, or QI) or any other MEC group, he or she should be moved to the MSP group or another MEC group. If the client is not eligible for any program, maintain eligibility on his or current program.