States May Not Terminate Medicaid Benefits During the Coronavirus Pandemic

By Lorese Phillips, Esq.

Access to affordable medical care is especially important during a global health crisis.  You should be aware that federal law prevents states that have accepted increased Medicaid funding from terminating Medicaid benefits while the coronavirus health emergency continues. New York is among those states, by accepting $323 million in enhanced Medicaid matching funds provided in the Families First Coronavirus Response Act.

The Secretary of Health and Human Services declared a nationwide public health emergency for COVID-19 earlier this year.  In light of the public health emergency, the Families First Coronavirus Response Act was enacted and provides that if you were enrolled in Medicaid as of March 18, 2020, the state (provided it accepted expanded Medicaid funds during the crisis) cannot terminate your benefits even if there is a change in your circumstances that would normally cause your benefits to be stopped. The law states that your Medicaid coverage must continue through the end of the month in which the Secretary declares that the public emergency has ended, which has not yet occurred. The only exceptions to this non-termination rule are if you choose to terminate your benefits yourself or you move to another state. 

States that already terminated a Medicaid recipient’s benefits should have contacted, and should still be contacting, recipients and encouraging them to reenroll. If the state determined that you were “presumptively eligible” for benefits before March 18, 2020, this rule does not apply to you, and the state may terminate your benefits if it eventually concludes you are not eligible for benefits. However, if you have coverage because you are appealing a decision of ineligibility that was made before March 18, 2020, the state cannot terminate your benefits during the health emergency. 

Specifically, New York State issued a directive in April stating that all Medicaid cases were being extended and “individuals will not be required to renew their Medicaid eligibility during the emergency period.”  Furthermore “[a]ll active Medicaid cases with authorization and coverage dates ending in March, April, May and June will be systemically extended for 12 months.”  

The New York City Human Resources Administration issued its own directive on June 22, 2020 stating that during the COVID-19 emergency, no Medicaid cases will be closed for failure to renew or failure to provide documentation, and that renewals also due in July and August, as well as the prior 4 months, will be extended for 12 months.   

Even though Medicaid renewals have been extended in New York during this emergency period the State enacted cuts to its Medicaid program on April 1. However, due to the coronavirus crisis those cuts are not scheduled to take effect until October 1. To learn more about the upcoming drastic cutbacks, refer to our webinar, “Medicaid Cutbacks: Get the Facts Before Rules Change,” and our blog post, “Drastic Changes to New York Medicaid Home Care to Start October 1.”

Pierro, Connor & Strauss, LLC assists seniors with chronic care health needs and individuals with disabilities to qualify and apply for Medicaid Benefits. If you have any questions or concerns, we would be happy to meet with you. Please contact us to schedule a free consultation by calling 1-866-951-PLAN.