Medicaid Phase Out Expected To Cause Coverage Shakedown

The dissolution of the PHE also means the end of the enhanced federal contributions distributed to the state Medicaid programs. It is expected that beginning April 1, 2023, states will begin disenrolling beneficiaries who do not meet pre-PHE eligibility measures.

Downstream waves will affect all stakeholders during the suspected dis-enrollment ramp-up period. An increase in uninsured consumers, heightened claim denials for medical providers, backlog to case worker re-enrollment efforts, and ultimately payment clawbacks are all likely.

Providers and their staff can brace for these changes by verifying patient coverage and eligibility on the date services are provided, and by communicating eligibility discrepancies with the patients affected.

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For Billing questions, please contact Bambi Akright at 716-389-3223 or bambia@pracfirst.com.