With the Friday, July 1, deadline looming for the launch of the next generation of Managed Care plans, officials with the Ohio Department of Medicaid (ODM) faced a difficult series of questions at a recent meeting of the Joint Medicaid Oversight Committee (JMOC).
Shortly after taking office, Ohio Governor Mike DeWine instructed ODM Director Maureen Corcoran to rebid and redesign Ohio’s managed care program. ODM has spent considerable time and resources to design the new program, meet with stakeholders, and coordinate the technical aspects of the new system. With a go-live date of Friday, July 1, which was pushed back from January 1 of this year, ODM is facing increased pressure to reassure lawmakers that the new system will be ready. During the JMOC meeting, ODM staff commented that a contingency plan was being prepared in case Friday, July 1, is unworkable.
JMOC members also pressed ODM staff on plans to redetermine eligibility for current enrollees following the expiration of the current Public Health Emergency (PHE) declaration by the U.S. Department of Health and Human Services, which is expected to occur later this year. At the onset of the COVID-19 pandemic, Ohio and most other states accepted enhanced Medicaid reimbursement from the Federal Government in exchange for freezing Medicaid redeterminations, meaning no individuals could be removed from Medicaid even if their income or health status had changed and they were no longer eligible. As a result, Ohio’s Medicaid enrollment is projected to be inflated by about 400,000 enrollees. The Centers for Medicare and Medicaid Services (CMS) has committed to providing states a 60-day notice when the PHE will expire and ODM will have an additional 60 days after the date of expiration to complete the redetermination process and remove ineligible enrollees. Members of JMOC are skeptical that ODM can complete the various tasks that are required for this process within the four-month window. Expect to hear more about this once CMS announces the expiration of the PHE later this year.