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Thousands of Colorado Medicaid recipients improperly disenrolled under new federal guidance


Thousands of Colorado Medicaid recipients improperly disenrolled under new federal guidance

Sep 25, 2023 | 7:23 pm ET
By Lindsey Toomer
Thousands of Colorado Medicaid recipients improperly disenrolled under new federal guidance
The Colorado Capitol on May 9, 2023. (Sara Wilson/Colorado Newsline)

Colorado is one of several states whose Medicaid automatic renewal system wrongfully disenrolled thousands of eligible recipients under new federal guidance.

Coloradans who think they may have been improperly disenrolled from Medicaid can contact their local county department of human services. 

The federal Centers for Medicare and Medicaid Services recently changed its guidance regarding state systems that automatically determine whether a recipient is eligible for reenrollment. While the systems used to make assessments by household, they are now required to do so individually, and several states need to modify their systems to comply with the new process. 

CMS warned states at the end of August that renewal systems have been disenrolling full households while some individuals are actually still eligible, and a new report shows how many people are potentially affected in which states. 

Marc Williams, spokesperson for Colorado’s Department of Health Care Policy and Financing, said the state found 10,044 individuals in the state were dropped because they didn’t turn in renewal paperwork after the automatic system was unable to determine their eligibility. This accounts for 0.5% of Colorado’s 1.8 million Medicaid members. 

“It is very important to us that we ensure the highest level of accuracy for our renewals so that eligible members can stay covered,” Colorado Medicaid Director Adela Flores-Brennan said in a statement. “We are implementing this new CMS guidance, and the short term changes requested as quickly as possible, while also proceeding with thoughtful intentionality to make sure that we are doing it right. We still need our members to pay attention to their mail and email and send in their renewal packets right away.”

The CMS report says Colorado’s automatic renewal system is not yet able to conduct renewals on an individual basis, which could impact over 10,000 children and household members with varying eligibility statuses.

Natalie Coulter, a spokesperson for HCPF, said that as soon as the state received word of the new CMS guidance, it worked to develop a plan to get into compliance and submitted it for federal approval within two weeks. 

“While the revised CMS guidance will increase automation and efficiencies over the long term, this new guidance will require significant changes to the state’s shared eligibility system that will need to be completed through a phased approach,” Coulter said in an email. 

According to the latest information from CMS on Sept. 21, 23 states and territories are properly conducting automatic renewals on the individual level. Colorado is one of 30 states, including Washington D.C., that are not properly conducting automatic renewals or are still reinstating affected members.  

Coulter added that HCPF is working on another strategy to support members who may have been improperly disenrolled if their household did not complete the renewal application. She said members who are eligible will be notified once the strategy is complete. The department also has resources related to other forms of affordable health coverage for those who may be disenrolling from the state’s Medicaid program. 

The change to the automatic reenrollment system comes with the end of the public health emergency in place since the height of the COVID-19 pandemic in 2020.