Wiki Medicaid Retro Disenrollment

[lolahead2012]

How is everyone handling the medicaid retro disenrollment for patients that were seen during the pandemic? We are up to $2000 just since Monday of "Overpayment Requests" from MCO's here in Kentucky for patients that were eligible and after the retro disenrollment they want the payments back.

 

[sls314]

How is everyone handling the medicaid retro disenrollment for patients that were seen during the pandemic? We are up to $2000 just since Monday of "Overpayment Requests" from MCO's here in Kentucky for patients that were eligible and after the retro disenrollment they want the payments back.

Are you referring to the Medicaid unwinding after the PHE ended, or something else? For the Medicaid unwinding, if a patient failed to respond to verification requests, they would lose coverage.

If a member was terminated, they have 90 days to respond to notices to have coverage reinstated.

Here's a link for Kentucky Medicaid geared towards members: https://khbe.ky.gov/Enrollment/Pages/PHEUnwinding.aspx

If you have any patients you think might be within the 90 days to get reinstated, I would suggest you reach out to them and provided them with this information.

I work in Oncology, so we were proactive before the PHE ended. Our financial counselors identified and assisted any Medicaid patients to ensure that they were responding to renewal notices and submitted necessary information to the state. (Of course, that's probably not practical in all types of practices, but with Oncology patients it was crucial to make sure they didn't lose coverage in the middle of treatment!)