Post on 13-Dec-2015
Washington Apple Health
WCOMOAmy Johnson, Eligibility Policy and Service DeliveryDecember 5, 2014
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Conversion of MAGI Medicaid
Even with efforts made by HCA, individuals continued to struggle to complete their conversion of health coverage into Healthplanfinder and the renewal rate was at 28%
• Extension of renewals for 3 months• Sending of a 4th notification letter• Conversion letters mailed through 9/30/14
As of September 2014, the renewal rate has returned to pre-ACA levels
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Apple Health (Medicaid) Renewals
For individuals receiving Apple Health MAGI Medicaid* through Healthplanfinder:
• 60 days prior to an Apple Health recipient’s renewal due date, the Healthplanfinder system captures the individual’s original application and determines whether he or she is eligible for auto-renewal
• Individuals will be notified whether they have been auto-renewed or that they could not be auto-renewed and must complete a manual renewal
*MAGI Medicaid: Family, Children, Pregnancy and Adult medical programs
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Auto-Renewal Vs. Manual
Auto-Renewal• Data-match finds household under the Medicaid
standard • No data-match found and income on file under the
Medicaid standard • No additional information needed by recipient • Recertified for twelve months
Manual• Data-match finds household above Medicaid standard• Individual must manually complete their renewal
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December Renewals
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Total Individuals
Auto-Renewed
% RequireManual Renewal
%
241,775 148,453 62% 93,322 38%
Estimated Renewals
• Roughly 56% of total MAGI Medicaid households up for renewal over a 4 month period (December – March)
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Month Total Assistance UnitsDecember 2014 194,549January 2015 88,133February 2015 124,857March 2015 73,471
Auto-Enrollment Waiver
• 1115 Waiver currently under development to auto-enroll individuals in the following programs:
ABD Cash/HEN TANF Cash
Pending Subpopulation of SNAP
• An individual receiving ABD/HEN/TANF assistance would be auto-enrolled into MAGI-based health care coverage during an overnight batch process (similar to SSI process)
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Hospital Presumptive Eligibility
As required under the ACA, the Health Care Authority (HCA) has established guidelines and standards for implementing the Hospital Presumptive Eligibility (HPE) program. HCA goals include:
• Provide a pathway to regular Apple Health coverage• Expand Apple Health eligibility training on the
Washington Healthplanfinder to hospital staff• Implement HPE as a safety net to ensure appropriate
access to care by eligible populations
HPE training of hospital staff scheduled to begin in early January 2015.
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Health Coverage Form 1095-B
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Purpose: To report information to the IRS and about individuals who are covered by Minimal Essential Coverage (MEC).
• Optional in 2014• Required for tax year
2015 (when filing in 2016)
More information related to the ACA: www.irs.gov/ACA
Resource Information
HCA Medicaid Expansion www.hca.wa.gov/hcr/me
• Training & Education www.hca.wa.gov/hcr/me/Pages/training_education.aspx
HCA Community-based training Resources & workarounds Reference guides Apple Health webinars Apple Health outreach materials
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Questions?
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