HomeHealthHealth CareFollowing lack of federal PHE-ending notification, HCPF provides updated PHE unwinding plan...

Following lack of federal PHE-ending notification, HCPF provides updated PHE unwinding plan for Colorado – State of Reform

The Department of Health Care Policy & Financing (HCPF) organized an information session on Thursday about preparing for the end of the Public Health Emergency (PGO).

The end of PHE is scheduled for January 11, but since the Biden administration has not announced that it would officially end by the 60-day mark on November 12, the state of emergency is expected to be extended for another 3 months.

During the virtual session, HCPF officials confirmed that the lack of federal notice implies that the PHE will be extended until at least April 2023.

HCPF outlined 3 key operational goals for the dissolution: continuity of coverage by members, smooth transition experience for members, and minimizing the impact of the dissolution on state personnel and eligible employees.

The department presented an overview of resources and timelines for partners to help the state’s 1.7 million individuals who receive continuous coverage prepare for and participate in the renewal process.

“CMS, our federal partners have also provided states with temporary strategies to handle this heavy workload and requirement for us. They have issued temporary waivers such as 1902(e)(14)(A) waivers and changes to the contingency plan,” said Marivel Klueckman, director of fitness at HCPF.

For Colorado, we looked at all of them and we chose to ask for a waiver to accept [instances where patients have no] income. If a member or an individual indicates that they are not working and if they have no income, and we’re going to verify it with the interface and nothing comes back, at that point, based on this waiver, we’re just going to accept it and then we will proceed without requesting additional verification. Once we get past settlement, additional verification would be required.

The federal government requires states to start and complete the renewal process within 14 months after the PGO ends. HCPF estimates that up to 350,000 could lose coverage unless their information, including their adjusted adjusted gross incomeis up to date.

HCPF will make new decisions for renewal 2 months before the expiration of a case. If the case qualifies, the renewal will happen automatically without any contact.

If a case is determined to be ineligible based on the information on file, a renewal package and communication will be sent requiring the individual to sign and update their information. Based on the updated information, those who do not qualify will lose coverage. Those individuals would be hooked up to plans with lower costs and other aid-related resources.

Klueckman emphasized the importance for his community partners to help members process the renewal package quickly and properly and to keep their information as current as possible.

Based on the expected termination in April 2023, the first set of coverage terminations would occur in May 2023.

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