Medicaid Redetermination

Department of Health and Human ServicesCenter for Medicare & Medicaid Services

Mar 20

With the conclusion of federal health emergencies, states are unwinding their Medicaid and Children’s Health Insurance Program (CHIP) rolls to remove ineligibles. During COVID, in exchange for a higher Federal Medical Assistance Program rate, states had to freeze cleaning up their rolls and now are in the redetermination process.

The Center for Medicare and Medicaid Services (CMS) claims that some states are removing eligible recipients. CMS sent letters to Medicaid directors, and even issued a pause on approximately 12 states’ redetermination process. Lawsuits against individual states have also started. Most recently, CMS contacted states about an ex parte issue focused on how states contact households versus individuals. CMS is attempting to force those states to put everyone back on the program and restart the redetermination process.