LAS VEGAS (KLAS) — A flawed process that was kicking children off Medicaid has been halted about a quarter of the way through a systemwide review of eligibility in Nevada.
Currently, state officials have not provided an estimate of how many people were affected before the problem was caught.
In June, the Nevada Division of Welfare and Supportive Services (DWSS) began a yearlong review of Medicaid recipients to remove people who were no longer eligible under the COVID-19 public health emergency. That emergency officially ended in May.
At the time, Nevada officials estimated 200,000 people were receiving benefits due to the emergency. Overall, about 930,000 Nevadans were receiving Medicaid benefits.
The Medicaid “unwinding” started in June, and the process to notify people who no longer qualified began. A new batch of notices were to go out each month, along with a concerted effort to make sure people found health insurance. Most people who lost Medicaid were picking up coverage through Nevada Health Link.
But a notice on Aug. 30 from the Centers for Medicare and Medicaid Services (CMS) indicated the need for all states to “determine whether they have an eligibility systems issue that could cause people, especially children, to be disenrolled from Medicaid or the Children’s Health Insurance Program (CHIP) even if they are still eligible for coverage, and requiring them to immediately act to correct the problem and reinstate coverage.
Nevada’s renewal process wasn’t in compliance, according to DWSS, prompting an abrupt stop to the yearlong effort.
The problem is that Medicaid eligibility for entire households was being rejected if a single member of the household didn’t qualify. The process was supposed to preserve eligibility for children and other “members of a household who have a higher-income eligibility limit.” Instead, everyone in the household was disenrolled.
“The Division will be pausing procedural terminations while waiting for additional guidance from CMS on how to reinstate Medicaid coverage for individuals determined to be disenrolled that would have remained eligible under these guidelines,” according to a DWSS spokesperson.
CMS advised states to immediately pause disenrollments and reinstate coverage for affected individuals.