Letter to Director Heredia includes implementation strategies for process improvements

TUCSON, Ariz. – Today, following data that shows that nearly 150,000 Arizonans have lost Medicaid and KidsCare coverage as a result of the end of the COVID-19 public health emergency through its unwinding process, Rep. Grijalva wrote to Arizona Health Care Cost Containment System (AHCCCS) Director Carmen Heredia urging additional action to ensure individuals are not losing health coverage due to procedural reasons.

Rep. Grijalva also encouraged Director Heredia to exercise existing federal authority from the recently released Center for Medicare and Medicaid Services (CMS) Strategies to Prevent Procedural Terminations which includes the ability to delay procedural terminations for beneficiaries for at least one month while the state conducts targeted renewal outreach.

“I am writing regarding Arizona’s Medicaid and Children’s Health Insurance Program (KidsCare) unwinding progress and to encourage you to modify and adopt additional strategies to ensure individuals are not losing health coverage simply because of procedural reasons,” wrote Rep. Grijalva. “I am concerned with this rapid rate of coverage loss and the ability of our health care system to absorb an influx of uncompensated care. While I understand some individuals may be reinstated or be eligible for coverage elsewhere, I ask you consider the following improvements to your unwinding process:

1. Act swiftly to extend the 30-day response period. 30 days is the minimum response time required by law and Arizona can easily expand this timeframe to help maximize responses.
2. Couple an extended response time with follow-ups notices for any non-responses. Multiple notices with appropriate time to respond can help capture incorrect addresses and compel individuals to return renewals.
3. Improve labeling on notices. Renewal notices should have appropriate labeling to distinguish them from nonurgent mail. A red stamp or print could increase open rates. 
4. Renew eligibility on an ex parte basis based on financial findings from Supplemental Nutrition Assistance Program and Temporary Assistance to Needy Families programs. 
5. Renew eligibility on an ex parte basis for individuals with incomes at or below 100% of Federal Poverty Level and no data returned.
6. Further coordinate with managed care plans by sending lists for individuals at risk of losing coverage and asking them to follow up with individuals that have been procedurally removed and may be eligible for the 90-day reinstatement period.
7. Work with pharmacies so that they may provide appropriate notifications and connection to health assisters for disenrolled individuals, as they may learn of their coverage loss when they go to pick up prescriptions.
8. Continue to leverage healthy Arizona partners in community by conducting regularly scheduled calls and collecting real-time feedback.
9. Work with stakeholders to make sure they are getting all available data they need so they can better target and adjust their outreach immediately.”

The full letter to Director Heredia can be found here.