LAS VEGAS (KLAS) — Nevada has reinstated Medicaid coverage to about 114,000 people who were caught up in a procedural problem that had eliminated their health care benefits.
Many of those who temporarily lost coverage were children on the Children’s Health Insurance Program (CHIP).
Individuals will receive a notice in the mail to tell them their coverage was reinstated.
The Division of Welfare and Supportive Services (DWWS) reported Friday that coverage was back in place for people who had been automatically disenrolled because they didn’t return renewal documents. The agency calls that “procedural denial.”
The state has been working over the past two weeks to adjust after they were notified by the Centers for Medicare and Medicaid Services (CMS) that eligibility for Medicaid must be evaluated for each individual. Nevada’s procedure had evaluated eligibility on a household basis, and if anyone in the household failed to respond, the entire household was knocked off Medicaid.
On Tuesday, the state estimated that 130,000 people had lost Medicaid coverage when they were still eligible. The number was revealed as a DWWS manager relayed information to Gov. Joe Lombardo during a meeting of the Nevada Board of Examiners.
The eligibility review began in the spring as the COVID-19 public health emergency ended. It was known as a Medicaid “unwinding” process. The plan was to send renewal packets to Medicaid recipients based on their enrollment date, with a new batch of packets going out each month for a year. Three months into the process, CMS notified at least 10 states including Nevada of the mistake in eligibility criteria.
Now, the review is scheduled to begin again in January 2024, but it will be done differently. A packet won’t go out if the government can determine eligibility based on their records. “The updated information provided by the federal government requires DWSS to evaluate eligibility based on electronic data sources per individual and only require a renewal packet for those whose eligibility cannot be confirmed using electronic data sources,” according to DWWS.
The agency advises anyone who lost coverage to notify their medical providers “to address any billing and payment concerns and to secure potential reimbursement of Medicaid-covered services.”
Individuals enrolled in Medicaid are urged to visit Update My Address and provide their current contact information to ensure they receive and respond timely to communications regarding their enrollment.
For information on existing Medicaid cases or how to apply for Medicaid, visit Access Nevada.