2019 has been big year for states making changes to their Medicaid requirements. More states are moving forward with either full or modified Medicaid expansion. Additionally, many states have approved Section 1115 waivers to operate their Medicaid programs, which will have a significant impact on who is eligible for coverage.
Source: KFF, Status of State Medicaid Expansion Decisions: https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, New Hampshire, New Mexico, and Ohio approved Section 1115 waivers, however, the waiver provisions related to the work requirement were set aside by the courts on March 27, 2019.
Idaho’s governor signed a bill on April 9, 2019 to seek a Section 115 work requirement waiver and to proceed with a partial, up to 100% FPL, Medicaid expansion.
Maine implemented expansion on January 20, 2019 & provided coverage retroactive to July 2, 2018 on April 3, 2019.
Nebraska delayed implementation until October 1, 2020 to seek a Section 115 waiver.
Utah began a partial expansion on April 1, 2019 for individuals up to 100% FPL
Virginia expansion became effective on January 1, 2019
The Wisconsin legislature voted to not fully expand Medicaid on June 4, 2019, but did pass significant increases in Medicaid spending
Why this matters?
Anytime requirements change, either expanding or restricting who is eligible for coverage, adds complexity for hospital financial counselors. They must quickly come up to speed on the new requirements, update how individuals are screened, and learn which new forms or attachments are required. If they don’t then your hospital will miss out on getting patients enrolled in coverage and lead to reduced reimbursement.
Advocatia can help
Advocatia makes the financial assistance experience for hospital staff more efficient. Our mission is to utilize technology to ensure all eligible individuals can receive health coverage. We streamline how financial counselors identify financial assistance programs for self-pay patients and enroll them into coverage. When states make program changes these are immediately incorporated into our platform’s logic, meaning that your staff can continue to get patients enrolled.