September 05, 2023
State Secures Federal Approval to Simplify Medicaid Unwinding, Keep More Georgians Covered
Atlanta, GA – After pushing for greater flexibility to help eligible Georgians keep their Medicaid and PeachCare for Kids® coverage, Georgia has received federal approval to use seven waivers to improve the “Medicaid unwinding” process. Across the nation, states are redetermining the eligibility of every person on their Medicaid rolls through this federally mandated process initiated by the Biden administration on April 1, 2023.
Already, Georgia has used waivers to auto-renew coverage for over 115,000 Georgians, counting people who were renewed early and not included in the state’s monthly report submitted to the Centers for Medicare & Medicaid Services. These include children, pregnant women, low-income families, individuals with disabilities, and senior citizens. What’s more, the State’s newest eligibility category – Georgia Pathways to Coverage™, conceived by Governor Kemp’s administration through the Patients First Act – went live on July 1, 2023, to expand coverage options for low-income adults. The below waivers have been in place for several months now and will continue until further notice.
| ▪ | Targeted SNAP Strategy: Now, state eligibility workers can use existing state records for Georgians receiving SNAP to auto-renew their Medicaid coverage, reducing the forms required from clients already enrolled in multiple public assistance programs. |
| ▪ | Targeted TANF Strategy: Similar to the State’s Targeted SNAP Strategy, this waiver empowers state workers to use existing information from a person’s TANF case to auto-renew their Medicaid coverage. Already, more than 60,000 Georgians on SNAP and/or TANF and Medicaid have had their coverage auto-renewed because of the Targeted SNAP Strategy and Targeted TANF Strategy waivers. |
| ▪ | Beneficiaries with No Income Renewal: This waiver authorizes state workers to auto-renew a person’s Medicaid coverage if their zero-dollar income was verified via an initial application or renewal completed no earlier than March 2019 and no new financial information is returned through the auto-renewal process. |
| ▪ | Streamlined Asset Verification: For the client, this waiver means they won’t have to turn over as much paperwork to state workers since the State will get it directly from the source, reducing the burden on Georgians receiving Medicaid and PeachCare for Kids®. Over 55,000 Georgians have been auto-renewed because of this waiver. |
| ▪ | MCO Beneficiary Contact Updates: By empowering managed care organizations (MCOs) to proactively assist Medicaid members, the State believes it will reduce the likelihood of procedural closures, take administrative burdens off those enrollees, and keep more eligible Georgians covered. |
| ▪ | NCOA and/or USPS Contact Updates: This waiver gives state workers the ability to cross-reference U.S. postal databases and update addresses for Medicaid members, increasing the likelihood that the State successfully contacts enrollees, reducing the likelihood of procedural closures, and preventing unnecessary churn. |
| ▪ | Fair Hearing Timeframe Extension: Now, the State is able to give clients extra time to request a fair hearing and potentially have their coverage retroactively reinstated. |
Georgia Department of Human Services (DHS) Commissioner Candice Broce and Department of Community Health (DCH) Commissioner Russel Carlson have issued the following joint statement on how the State is leading national efforts to streamline the redetermination process and help more eligible Georgians stay covered:
“Due to federal law and rules, Georgia must review the eligibility of millions of Georgians on Medicaid/PeachCare for Kids®, and the State is working hard to make this mandatory process as painless, efficient, and customer-focused as possible. Through federal flexibility to better serve children, people with disabilities, low-income households, and older Georgians, Georgia’s waivers are already working to prevent unnecessary denials of coverage. We applaud our community partners for their invaluable advice and support throughout Medicaid unwinding, and we will continue to seek out innovative ways to help every eligible Georgian stay covered.”
People who currently have Medicaid or PeachCare for Kids® should visit gateway.ga.gov to find their redetermination date, which is when their paperwork is due to the State. Extensive communications efforts have been made – and are continuing to be made – to ensure people are prepared to respond to the State’s requests. If someone loses coverage during redetermination, they still have options. If the only issue is that the person failed to submit the necessary documents before their due date, they have 90 more days to submit the proper paperwork and potentially regain their coverage. If someone is no longer eligible for Medicaid or has aged out of PeachCare for Kids®, they may qualify for Pathways or they can explore the marketplace to compare private healthcare plans.
There are three easy ways for Georgians to make sure their Medicaid case contains accurate information ahead of their redetermination date:
| 1. | Online at gateway.ga.gov |
| 2. | In person at their local DFCS office: dfcs.georgia.gov/locations |
| 3. | By phone at 1-877-GA-DHS-GO (1-877-423-4746) or 711 for the hearing impaired |
Members, their loved ones, partners, and providers can find more information in multiple languages at the State’s official websites: staycovered.ga.gov and siemprecubierto.ga.gov.