In a recent development, Nevada will rectify a significant administrative error that resulted in the loss of Medicaid coverage for approximately 130,000 people, most of whom were children.
The revelation came to light during a meeting between Governor Joe Lombardo and the Nevada Board of Examiners.
Medicaid Review Error Prompts Swift Action in Nevada
The issue first came to the public’s attention by 8 News Now.
The overwhelming number of individuals affected was disclosed in the most recent meeting.
Kelly Cantrelle, the Division of Welfare and Supportive Services’s Deputy Administrator, explained the situation to the governor.
The issue’s core is a one-year ‘ex-parte’ review of Medicaid recipients.
The primary objective of this review was to identify and remove Medicaid-ineligible individuals as a result of the expiration of the COVID-19 public health emergency.
Each month, a collection of Medicaid recipients was reviewed, and notifications were sent to those deemed ineligible.
This evaluation process began in June.
However, complications arose when it was discovered that the entire household would be terminated if a single member failed the ex-parte review for any reason.
This practice was historically known as a ‘procedural termination.’
The Centers for Medicare and Medicaid Services (CMS) issued an important notice on August 30 stating that the review procedure should not result in household-level terminations.
CMS’s investigation revealed that ten to thirteen states, including Nevada, improperly applied procedural terminations at the household level rather than evaluating each individual’s eligibility separately.
Nevada suspended its review procedure immediately in response to CMS’s findings.
Read more: Healthcare Providers Explained: Physician Assistant, Nurse Practitioners, And Doctors
Hope Renewed: Medicaid Restoration in Nevada
Kelly Cantrelle confirmed that the necessary modifications are being implemented and that the review process will recommence in January 2024, with notifications to be sent out.
Medicaid recipients who remain eligible under the COVID-19 public health emergency rules will continue to have access to Medicaid until their reviews are conducted.
During the transition period, this provision ensures that Medicaid-eligible individuals continue to receive the essential healthcare services they rely on.
CMS’ intervention highlights the significance of this issue, as household evaluations incorrectly denied Medicaid or Children’s Health Insurance Program (CHIP) benefits to many individuals who should have remained eligible.
The reinstatement of Medicaid coverage for approximately 130,000 individuals provides a glimmer of hope and much-needed relief to those who depend on these essential healthcare services.
While the procedural error has undoubtedly caused anxiety and concern for those affected, Nevada’s swift action to rectify the situation demonstrates the state’s dedication to ensuring that all eligible individuals have access to healthcare.
As the review process is scheduled to recommence in early 2024, many Nevadans can anticipate recuperating the vital Medicaid coverage they and their families require.
Read more: High Healthcare Costs For Retired Medicare Recipients