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Washington Apple Health WCOMO Amy Johnson, Eligibility Policy and Service Delivery December 5, 2014.

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Presentation on theme: "Washington Apple Health WCOMO Amy Johnson, Eligibility Policy and Service Delivery December 5, 2014."— Presentation transcript:

1 Washington Apple Health WCOMO Amy Johnson, Eligibility Policy and Service Delivery December 5, 2014

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3 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 4 th notification letter Conversion letters mailed through 9/30/14 As of September 2014, the renewal rate has returned to pre-ACA levels 3

4 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 4

5 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 5

6 December Renewals December Renewals 6 Total Individuals Auto- Renewed %Require Manual Renewal % 241,775148,45362%93,32238%

7 Estimated Renewals Estimated Renewals Roughly 56% of total MAGI Medicaid households up for renewal over a 4 month period (December – March) 7 MonthTotal Assistance Units December ,549 January ,133 February ,857 March ,471

8 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) 8

9 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

10 Health Coverage Form 1095-B 10 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:

11 Resource Information HCA Medicaid Expansion Training & Education  HCA Community-based training  Resources & workarounds  Reference guides  Apple Health webinars  Apple Health outreach materials 11

12 Questions? 12


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