Idaho might have broken rules in Medicaid unwinding, federal regulators warn

The letter federal regulators sent to Idaho doesn’t capture how Idaho began Medicaid unwinding earlier and the state’s process is more targeted than many other states, state officials say. | EastIdahoNews.com fily photo
BOISE (Idaho Capital Sun) — Idaho officials say that a letter from federal regulators that says Idaho may have broken federal rules in how the state removed people from Medicaid this spring doesn’t paint a full picture.
Idaho’s 51% procedural disenrollment rate was the second highest in the country, just behind Texas, at 52%. That’s according to the Idaho Capital Sun’s review of letters the Centers for Medicaid and Medicare Services, or CMS, sent to all 50 states and Washington, D.C.
“We urge caution in making comparisons across states’ data at this time. CMS has made note of cautioning any comparison data as all states have an independently approved unwinding plan that significantly impacts the information being reported,” Idaho Department of Health and Welfare spokesman Greg Stahl told the Idaho Capital Sun in an email on Wednesday.
Uncertainty looms as nearly 150,000 Idahoans could lose Medicaid
Idaho’s call centers were backlogged by half an hour longer than most states, with an average call wait time of 34 minutes — which was the seventh highest in the nation in May.
About 51 percent of people Idaho removed from Medicaid that month were disenrolled for procedural reasons, which means they didn’t reply to the state’s requests for information. The national median rate for procedural disenrollments was 10 percent that month.
The letter to state officials, sent August 9, doesn’t capture how Idaho began Medicaid unwinding earlier and the state’s process is more targeted than many other states, Stahl said. And Idaho is already working to improve metrics that the federal regulators flagged, including increasing staffing in the call center and the use of a call-back feature that connects enrollees with a customer service representative as soon as one is available, Stahl said.
Only four states started removing people from Medicaid by April and 21 prioritized at least some renewals for people who were likely ineligible, according to separate data from CMS.
“Few states are as far into unwinding as we are,” Stahl wrote, pointing out that 18 states hadn’t removed people procedurally by May, only 3 states had removed people in April and only six states removed people in May. “… Our being so far ahead likely skews the data for states who are just beginning: it is not helpful to compare states as the volume and strategy of who is included in each month vary drastically as that part was left up to each state to decide in their CMS approved unwinding plan.”
Idahoans who call the call centers for Medicaid renewal also don’t actually “wait” on the phone, Stahl said. They wait for a call back.
“While 34 minutes to receive a call back is longer than we would like, it is comparable to call back times during other peak times of (the) year, such as during Open Enrollment,” Stahl said, noting that people can also renew online at any time.
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Source: eastidahonews.com