The conclusion of the Public Health Emergency (PHE) will bring about the end of several temporary authorities adopted at the federal and state level during the COVID-19 pandemic. Included in this is the expiration of the continuous coverage requirement authorized by the Families First Coronavirus Response Act (FFCRA), which will be the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act.
This page includes resources to help Community Health Centers prepared for the PHE unwinding of Medicaid and CHIP coverage. MPCA will continue to update this page as additional tools and materials are released.
State of Maine Resources
- MaineCare Unwinding Communications Toolkit
- COVID-19 Public Health Emergency Unwinding Plan for Resumption of Normal MaineCare Eligibility Operations
- Preparing for the End of the COVID-19 Public Health Emergency
- Outreach Materials:
- Unwinding Communications Toolkit (PDF)
- Unwinding Fillable Flyer (PDF)
- MaineCare Contact Update Flyer (PDF)
- Stay Connected to Stay Covered Videos:
- Misc. MaineCare Updates:
End of the Federal Public Health Emergency (PHE) Provider Mailbox
Apr 06, 2023
On January 30, 2023, the Biden-Harris Administration announced that the federal COVID-19 PHE will end on May 11, 2023. The Department is diligently reviewing all PHE-related flexibilities and is developing guidance to clearly articulate what flexibilities will end, along with associated timeframes. We plan to update our website resources and send out additional e-messages over the coming weeks and months. In the meantime, we are happy to address questions as they arise so your teams can prepare for any transitions ahead.
To support the MaineCare providers through this transitional period, MaineCare developed a provider-only mailbox to submit questions related to the end of the PHE. Providers may submit questions to DHHSMaineCareEndofPHE@maine.gov.
The end of the continuous coverage requirement on March 31, 2023, also known as “unwinding” by the federal government, is no longer associated with the end of the PHE. If providers or members have questions about the end of the continuous coverage requirement, they should visit www.mainecare.gov/unwinding for FAQs, a communications toolkit, and additional information. The provider PHE mailbox cannot answer questions regarding unwinding.
Federal Resources
- Latest Guidance on Medicaid Redeterminations (CMS, 3/23/23)
Medicaid Renewals & Redeterminations:- There is no federal schedule for renewals (minus the 12–14-month guidance).
- For MAGI populations states must provide a minimum of 30 days for individuals to respond to renewal letters.
- Non-MAGI populations are left up to the states (states must provide a reasonable amount of time to respond to letters).
Next Steps After Losing Medicaid Coverage:- If a renewal form is not submitted on time Medicaid coverage will end.
- There is a 90-day reconsideration period to reprocess eligibility due to procedural loss of coverage.
- So, individuals should get their renewal forms submitted even if they are late.
Medicaid To Marketplace Transitions- When an individual is found to be ineligible for Medicaid coverage, the state agency will send the individual’s information to the marketplace.
- Individuals will then receive a form that will prompt them to log into the marketplace and apply.
- Consumers should wait for the state to conduct an eligibility review before applying to the marketplace.
- Even if they know they are no longer eligible for Medicaid.
- Individuals disenrolled from Medicaid coverage will not need to provide proof of lost coverage (due to the state agency contacting the marketplace about their disenrollment).
Special Enrollment Period:- Consumers who lose coverage will have 60 days from the day they submit their application to select a plan within the marketplace.
Losing Medicaid Coverage But Now Eligible for Medicare:- CMS has released guidance on what to do if an individual loses coverage but ages into Medicare. The resource can be found in the following link.
-
Medicaid and CHIP Beneficiary Resource Page (For individuals enrolled in Medicaid and CHIP to help prepare to renew their coverage when states restart eligibility renewals after the PHE.)
-
COVID-19 PHE Unwinding FAQ for State Medicaid and CHIP Agencies (CMS, 10/17/2022)
-
Strategies to Maximize Automation, Increase Renewal Rates, and Support Unwinding Efforts (CMS, 10/20/2022)
-
PHE Unwinding Readiness for Health Centers (NACHC Presentation, 06/29/2022)
- Top 10 Fundamental Actions to Prepare for Unwinding and Resources to Support State Efforts (CMS, 06/02/2022)
- Additional CMS Resources
Health Center O&E Stories Wanted
HRSA is in the process of collecting stories to highlight the strides that HRSA-supported health centers have made in promoting public health in underserved areas.
Given the increased focus on outreach and enrollment (O&E) activities as a result of the ending of the Medicaid Continuous Enrollment provisions and increased need for Medicaid eligibility redeterminations, NACHC is working with HRSA to promote the submission of stories related to outreach and enrollment!
If your health center has an innovative practice or story related to O&E to share, please submit it!
Here is the form the HRSA shared as guidance (it has been slightly modified to reflect O&E activities). Here is a link to the HRSA Health Center Stories webpage, which includes this link to a photo release form. When submitting your stories, feel free to include your PCA O&E point of contact and/or NACHC Director of Health Center Growth & Development, Ted Henson, thenson@nachc.org, for general awareness.
Partner Resources
PHE unwinding flyer for consumers provided by MPCA in partnership with Consumers for Affordable Health Care:
The Association of Clinicians for the Underserved (ACU) has released several documents to support CHCs and their patients during the Medicaid unwinding:
- Slides from a webinar on “Best Practices and Lessons Learned for Medicaid Redeterminations”, featuring two CHCs plus the Arizona and Illinois PCAs.
- Medicaid Redetermination FAQs for Community Health Centers
- Medicaid Redetermination Talking Points for Community Health Centers
- Medicaid Redetermination FAQs for Medicaid Beneficiaries
CMS Communication Toolkits
Medicaid and CHIP Unwinding
Back to School