CMS Taking Action Against States Over Kids Losing Medicaid Coverage Due to Flawed Determination Systems (September 6, 2023)

As school districts nationwide work to help children and families retain benefits amid the transition to automatic renewal systems due to the end of the pandemic, the Centers for Medicare and Medicaid Services (CMS) is threatening state Medicaid agencies with sanctions for improperly removing children from the safety-net coverage during ongoing eligibility checks resulting from the end of the public health emergency declared during the pandemic.

On Wednesday, August 30, 2023, all 50 states and Washington, D.C. received letters from the federal government after it was found that a number of states using automatic renewal systems to review the eligibility of families all at once, despite a lower bar for children that would allow them to remain eligible. Such action could result in eligible children improperly losing their Medicaid coverage.

The CMS is giving state until mid-September to assess their systems, pause disenrollments if they find errors, and reinstate coverage for any affected individuals.

Source: K-12 Dive. Click here for more.