Since the onset of the Public Health Emergency created by the COVID-19 pandemic, federal law has required each state to maintain Medicaid eligibility for its Medicaid recipients in exchange for receiving billions of dollars in Medicaid funding, commonly referred to as the continuous coverage requirement. Under the Families First Coronavirus Response Act (FFCRA), Medicaid recipients could not lose their coverage or have their spend-down increased after March 18, 2020 through the end of the Public Health Emergency, unless the recipient died, moved out of state, or voluntarily closed their case. As the Public Health Emergency has been repeatedly extended since March 18, 2020, these restrictions have remained in full force and effect for just under three (3) years.
However, in December 2022, President Biden signed into law the Consolidated Appropriations Act (CAA), implementing significant changes to the continuous coverage requirement. Most notably, the CAA unlinks the continuous coverage requirement from the public health emergency. This means that the states will be permitted to begin redetermining Medicaid eligibility as of February 1, 2023. Each state must initiate the renewal/recertification process for all Medicaid recipients by April 2023 and has fourteen (14) months to complete all redeterminations and renewals. Moreover, states may terminate Medicaid coverage based on those renewals starting April 1, 2023.
As a result of this change in the law, Medicaid recipients will receive renewals/recertifications to complete and return with documentation of income and assets. Many recipients who applied for Medicaid during the pandemic may have never had to do a recertification, while recipients who already had Medicaid coverage when the pandemic began may not have submitted a recertification for nearly three (3) years. If these recertifications are not timely submitted or if the recipient is found to be ineligible, Medicaid may be terminated. NAMI budgets may also change after a recipient’s income has been reviewed.
The implementation of the new law will almost certainly result in changes to Medicaid eligibility for many nursing home residents. New York is likely to begin its renewal process in April 2023, with the first terminations for those no longer eligible starting in July 2023. Now is the time to prepare recertification applications for your Medicaid recipients. Cona Elder Law can help.
Cona Elder Law’s experienced attorneys continue to monitor the most recent legislative developments and other important legal matters concerning the nursing home industry. Contact us at 631.390.5000 or click here to learn more about how our firm can help your facility preserve your bottom line and ensure your ability to continue to provide quality services to your residents.