Payer Update, June 2023

Payer Update
  • State Medicaid Redetermination in Process NOW
  • by Angela Blue, Director Member & Community Relations

    Many HTC patients may be at risk of losing coverage, or having their Medicaid coverage mistakenly terminated, even if they have been covered by Medicaid for many years. The end of the COVID-19 Public Health Emergency (PHE) ushered in the end of continuous enrollment in Medicaid and allowed states to re-start their Medicaid renewal application process. This is referred to as the Medicaid Unwinding or Redetermination period.

    During the PHE, State Medicaid agencies were NOT conducting regular reviews of their members. Anyone who was covered by Medicaid in March 2020 and/or went onto a Medicaid plan from March 2020 through March 2023 stayed on Medicaid without the typical annual review process to determine if they still qualified.

    Beginning in February 2023 states could start reviewing their Medicaid patients to determine if they still qualify. Early estimates predict that 15 million patients will lose their coverage over the next year, and up to 6.8 million of those members are still eligible but missed some part of the re-application process.

    We recommend that HTCs keep a list of their Medicaid patients as this process unfolds and contact them about the re-application process. If a patient’s contact info (address, phone, etc) has changed since they last applied for Medicaid, they may not receive the renewal information and their coverage could be terminated because of no response. It is important that patients update their contact information with the Medicaid agency.

    Some patients may no longer qualify for Medicaid because they aged out or had a change in income or household situation. These patients may need help finding a new plan through the State exchange or other means. Many Bleeding Disorders Chapters across the country are holding webinars and providing info to patients. We suggest reaching out to your local chapter to coordinate and collaborate in your efforts.

    Most states are processing the renewals throughout the next year, redetermining eligibility in the month that the member originally started Medicaid. The Georgetown Center for Children and Families has a great state tracking document that they are continually updating here. Please see the Alliance January Newsletter article for more details and resources.

    If you have questions or want more information, please contact your Alliance Member and Community Relations contact.


  • Linda Gammage Social Worker Planning Committee Member Needed
  • by Jeff Amond, Director Member & Community Relations

    The Hemophilia Alliance seeks to fill one vacancy on the Planning Committee for the Linda Gammage Social Worker Conference. Candidates are required to be currently employed at a federally supported HTC that is a member of the Hemophilia Alliance. This volunteer opportunity involves working collaboratively with other committee members to identify appropriate topics, recruit speakers and plan/evaluate programs. Committee members participate in conference calls and one in-person planning meeting per year (if needed). Committee members also have the added perk of getting a guaranteed spot at the conference. The role generally requires a commitment of about two hours per month. The term is three years. Interested individuals should submit their CV and a Letter of Interest to Jeff Amond at amond@hemoalliance.org by Friday July 12, 2023.

Also in this Issue…

Notes from Joe
· Going, Going …… Not so fast

Notes from the Community
· UC San Diego HTC Sponsors Course on Musculoskeletal Ultrasound
· Reminder: The 4th Annual Innovation Grant

Alliance Update
· New Product Guide Available
· New HTC Staff Meeting in NYC

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