Provides for automatic enrollment and recertification simplification for Medicaid eligible recipients

Showing the cosponsors who are on Agora, A to Z. The official record may list more.

• Democratic8

Shown in neutral colors by design; Agora is non-partisan.

◆ The sponsor's argument

Why Gustavo Rivera says this is needed

People who have successfully applied for Medicaid in order to enroll in a MLTC plan face many hurdles and delays before they are effectively enrolled. First, an in-home eligibility assessment by a nurse can take several weeks to schedule and this assessment is valid for only 75 days. After that assessment is completed, the Medicaid recipient will schedule in-home assessments with prospective MTLC plans to determine the level of care each will provide. It can take several weeks to schedule and complete those visits. Once the recipient agrees to a plan, the plan will process enrollment, which is effective either the first of the following month or, if it is already after the 18th, effective the first of the month after the following month. If 75 days have lapsed, the process restarts at the beginning, resulting in care delays. Currently, Medicaid recipients complete a mail renewal form, attesting to their income, once a year in order to continue to receive health care coverage. This is true even if the recipient is on a fixed income. The recertification process is so prone to errors that it frequently results in a discontinuance of eligibility. The recipient may not receive the discontinuance notice on time or at all, or may not be able to request a fair hearing within 10 days, which automatically triggers disenrollment. In 2011, the Medicaid program recognized the problems and initiated a demonstration program to automate renewals for Aged, Blind, and Disabled Medicaid recipients with fixed incomes. This bill extends the benefits of that demonstration to the rest of the program.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.