PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) released its fourth monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began on April 1, 2023.
Of the renewals initiated in August, more than 80% of members maintained their Medicaid coverage and 73% of those renewals were automatically determined to be eligible. The automatic process, known as ex parte, refers to an individual being determined eligible without the need for the member to provide additional information or proof. AHCCCS determines ex parte on the individual, not household, level, in compliance with CMS regulations.
More than 95,000 members who have been disenrolled since April for not responding to AHCCCS have taken advantage of the 90-day window to finish their renewal, with 48% of them meeting eligibility criteria and being reinstated.
To date, 32% of all enrolled members have met eligibility criteria and maintained coverage, 11% have not met eligibility criteria and have been discontinued, and 17% of the renewals are in progress, with 40% of renewals yet to be initiated.
Members may be discontinued if they no longer meet income or other eligibility criteria, (called “factual” disenrollment) or if their renewal is incomplete (called “procedural” disenrollment).
The number of procedural disenrollments includes members who may be over the Medicaid income limit, but who didn’t respond to the agency’s requests to verify income. Of the 289,124 who have been discontinued, 26% were factually ineligible and 39% were procedurally ineligible while appearing to exceed income limits.
Procedurally disenrolled members may have health care coverage from other sources, like employer-based insurance, or may have moved out of state without updating their contact information with AHCCCS.
This month, AHCCCS added city-level data to the dashboard about the remaining individuals due for renewal. City-level data is available for cities with a population of more than 20,000.
AHCCCS has implemented several updates and enhancements to help members complete their renewal, including:
AHCCCS restarted annual Medicaid renewals on April 1 and will determine eligibility for all 2.5 million members by March 2024. For more information on the regular Medicaid renewal process and to see the September AHCCCS renewal dashboard, visit the Renewals web page.
