Now that the federal Covid-19 public health emergency (PHE) has officially ended, states have begun the process to return to normal eligibility and enrollment operations. This process is resulting in more work as states begin the immense effort of reviewing millions of people’s eligibility status. Disenrollment numbers continue to climb with procedural reasons being a major reason for people losing coverage. According to KFF, 75% of disenrollments are due to procedural reasons, among states reporting as of July 13, 2023. The Centers for Medicare & Medicaid Services (CMS) is recognizing these challenges and providing states flexibility in their approaches to unwinding to help mitigate unnecessary disenrollments.
As a partner to several State Medicaid programs and Managed Health Care Organizations, we understand how large of an undertaking the PHE unwinding is for states who are dealing with workforce shortages. Due to our scalable operational model and industry experience, Noridian is well-positioned to help states and its partners alleviate higher work volumes by assisting with redetermination efforts while meeting unwinding requirements.
Noridian is qualified to help in these areas:
| Current Requirements that May Cause Challenges | How Noridian Could Help |
| States will need to have current enrollee contact information by using the United States Postal Service National Change of Address Database, state health and human services agencies, or other reliable sources of contact information. | Supporting education and outreach campaigns targeted to key community stakeholders by helping to update enrollee information.Create messaging for Medicaid members on where and how they can update their information. |
| States cannot disenroll anyone who is determined ineligible for Medicaid based on returned mail, without first trying to contact the individual using more than one modality (e.g., telephone and email). | Ability to augment your service capabilities and support your multi-channel contact center outreach through phone and mail.Document and track activities for CMS compliance. |
Additional information on directives CMS issued to the states can be found here and here.
Another option for states to consider is to outsource certain operational areas that may cause challenges and extra work for their departments. Our experiences in Medicaid and Medicare make us efficient at quickly deploying resources and developing processes to support your goals. Noridian’s nearly 60 years of operational excellence in areas such as staff augmentation, support call center services, and outreach and education, may be just what your state’s unwinding plans need for a smooth transition.
If you’re interested in learning more about Noridian may help with your PHE unwinding efforts, please reach out to me on our Contact Us page or connect with me on LinkedIn. I’d love to hear more about any challenges your state is facing and discuss if there’s an opportunity for Noridian to bring in our resources so you can focus on other top priorities for your program.