Please be advised that as we are beginning implementation of our unwinding plan. The following information is to aid you with determinations moving forward:
- All closure determinations at review are to resume effective immediately.
- Start applying negative actions (closures) if the household is no longer eligible or fails to complete the review process. (These include anyone over resource, over income, unable to locate, etc.)
- SMS (text) messages and email reminders are being sent. A team is being set up to make cold calls to assist the households with getting their reviews turned in, so that we can make this transition back to pre-Pandemic handling as smooth as possible.
- We redistributed cases and delinquent reviews to balance them out over the remaining course of the unwind. You may have noticed that some D10 dates have been moved around.
- Flexibility was granted to utilize strategies that allows to passively renew some medical cases. If you see the following case note: “MEDICAL Auto Renewed: Ex Parte process used based on e14 waiver strategy outlined in the CMS unwinding efforts”, please know that the case has already been reviewed.
- Doing a thorough case review before taking action could prevent someone from unnecessarily losing coverage when they should have been eligible. The households could be out of practice; therefore, be sure to review the systems, such as previous Case Notes, BENDX, SDX, ACES, AVS, OnBase & WorkFlow, which could prevent rework and loss of coverage.