Washington Apple Health

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Presentation transcript:

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

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

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

Auto-Renewal Vs. Manual 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

December Renewals Total Individuals Auto-Renewed % Require Manual Renewal 241,775 148,453 62% 93,322 38%

Estimated Renewals Roughly 56% of total MAGI Medicaid households up for renewal over a 4 month period (December – March) Month Total Assistance Units December 2014 194,549 January 2015 88,133 February 2015 124,857 March 2015 73,471

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)

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 2015.

Health Coverage Form 1095-B 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: www.irs.gov/ACA

Resource Information HCA Medicaid Expansion www.hca.wa.gov/hcr/me Training & Education www.hca.wa.gov/hcr/me/Pages/training_education.aspx HCA Community-based training Resources & workarounds Reference guides Apple Health webinars Apple Health outreach materials

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