PHE- HHS Moves to Restore Medicaid Coverage to 90,000 in Texas (Correct)

MM Curator summary

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[MM Curator Summary]: About 90k Texans are getting their Medicaid cards back. Best I can tell they were terminated due to errors in the TX IT system.



Clipped from:

The Biden administration is working with Texas to restore tens of thousands of people to the state’s Medicaid rolls who had lost coverage erroneously, a senior CMS official said Tuesday.

The Centers for Medicare & Medicaid Services worked with the state’s Medicaid agency to reinstate coverage for those individuals back to the date when their coverage was terminated, the official, who spoke on the condition of anonymity, told Bloomberg Law. The CMS didn’t require the state to pause terminations, the official said.

Roughly 90,000 individuals are expected to regain coverage by the end of this month, said another senior CMS official, who also spoke on the condition of anonymity. Most already have, that official said.

The officials’ remarks follow a letter from Democratic House members from Texas who urged the CMS to investigate reports of problems at the Texas Medicaid agency.

The lawmakers pointed to a whistleblower letter in which anonymous employees at the Texas Health and Human Services Commission alleged system failures leading to erroneous coverage terminations and burdensome manual reinstatements.

The whistleblower letter claimed approximately 80,000 individuals have already lost Medicaid coverage incorrectly, including thousands of pregnant women and seniors. Employees allege they were forced into overtime to process 6 million beneficiaries in eight months, contrary to federal guidance.

The Texas Democrats urged the CMS to intervene, alleging Texas is not complying with federal Medicaid requirements.

The Texas Department of Health and Human Services didn’t immediately respond to a request for comment.

The news comes after nearly 600,000 Texans have already lost Medicaid coverage in recent months, with most citing loss due to procedural rather than eligibility reasons. Medicaid eligibility checks had been paused during the Covid-19 pandemic, but have resumed in recent months.

The legislators warn another round of “catastrophic coverage losses” once Texas begins sending renewal notices next month to a third cohort of children, seniors, and disabled enrollees.

Rep. Lloyd Doggett, one of the Texas Democrats who signed the letter, said in a statement to Bloomberg Law that “CMS has the statutory authority and duty to intervene in this immediate health care crisis.”

He said he was “urging swift federal action to pause Medicaid redeterminations in Texas until a complete investigation and corrective action are undertaken to prevent catastrophic interruption of care for many disadvantaged families.”