Don’t Let Your Consumers’ Medicaid Fall Thru The Cracks

The original unwinding of Medicaid benefits coincided to end with the Public Health Emergency (PHE).  However, in late December, the omnibus spending bill, the Consolidated Appropriations Act was signed and separated the Medicaid continuous enrollment requirement from the ongoing PHE.

Congress is now allowing states to begin Medicaid eligibility redeterminations and renewals as of April 1, 2023, regardless of whether the COVID-19 PHE has ended.  States are not required to begin this process on April 1^st although, the enabling legislation contains financial incentives to do so.  The 6% FMAP provided to states during the PHE will be gradually phased out by December 31, 2023.  It is likely that most, if not all states will begin eligibility processes on April 1^st.

It is estimated that 18 million people could lose Medicaid benefits because they no longer meet Medicaid eligibility requirements or fail to make it through their state’s redetermination process.

Below are practical points to ensure consumer Medicaid benefits remain in place thru this transition period:

• Respond to redetermination documentation as quickly as possible
• Ensure your state agency has the correct address for your consumers
• Create an outreach to consumers’ family or guardian who may receive the redetermination notice
• Make sure your consumers’ assets are below their resource limit

It is not surprising that many of your consumers will have account balances that exceed their resource limit.  During the PHE, most consumers received three stimulus payments, totaling $3,200.  This, alongside consumers’ inability to get out and spend money has many checking accounts over resource thresholds.

If your consumers have excess money over the resource limit, you do not have to spend down the funds.  You can use an exempt resource account such as a special needs trust or ABLE account to store any surplus of funds, allowing consumers the ability to save money over their resource limit and still maintain benefits.  We believe the best exempt resource for a provider to use is its own special needs pooled trust (SNPT).

A SNPT brings many advantages to both consumer and provider.  When a consumer places their excess funds into a trust, this money can be saved and used by the individual as needed over their lifetime,  helping to enhance lives and improve outcomes.

A provider can adopt Arlington Heritage Group’s Provider Trust as their own.  It is a total business-to-business solution for administration, compliancy and reporting.  It will support your I/DD community and can help to offset capital intensity for individuals in your care.  It’s a transparent tool that can be used by executives, fiscal teams, DSP’s, family members and the individual, who can all interact with the trust account.

We have made it easy for providers to create their own special needs pooled trust.  We also provide the day-to-day support to run the SNPT.  This is all offered to the provider at no cost and there is a low-cost structure for consumers.

Arlington Heritage Group is an exempt resource expert and works exclusively with human service providers to help safeguard benefits and build resources for its consumers and I/DD community.  As a trust administrator for over 30 years, we now have over 100 non-profits that have made our special needs pooled trust their choice.

Take a quick look at our website or contact Kim Goodwin at [email protected] or call 215-672-1184, ext. 6.