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HFS: No pause on Medicaid disenrollments

22 Sep 2023 12:48 PM | Deborah Hodges (Administrator)

A spokeswoman for the Department of Healthcare and Family Services confirmed Thursday that they are not pausing Medicaid disenrollments in Illinois. [Health News Illinois]

That comes as the Biden administration ordered 30 states on Thursday to halt procedural disenrollments over concerns that a glitch in their eligibility systems caused children and other individuals to unintentionally lose coverage during the Medicaid redetermination process.

While Illinois was one of the 30 states identified by the U.S. Department of Health and Human Services, HFS spokeswoman Jamie Munks noted an HHS press release said the federal agency required the pause unless states “could ensure all eligible people are not improperly disenrolled due to this issue.”

“Starting this month, ex parte redeterminations are being conducted at the individual level, and HFS is working on reinstating the cases that were closed July 31 that would have been deemed eligible with this change,” Munks said. “As a result, Illinois has not paused Medicaid disenrollments.”

Munks noted that if the ex parte process is not successful, the Medicaid members are then sent renewal materials.

CMS sent a letter last month to all state Medicaid directors asking them to evaluate whether children in their states are being affected by Medicaid eligibility systems. For systems deemed faulty, the agency asked states to pause “procedural disenrollments” until the issue can be fixed.

Munks said the agency has been “working for weeks on a solution to allow for ex parte redeterminations at the individual level before any additional disenrollments occurred.”

HHS said Thursday that nearly 500,000 children and other individuals nationwide who were improperly disenrolled from Medicaid or the Children's Health Insurance Program will regain their coverage due to efforts to address the issue. The agency estimates that fewer than 10,000 Illinoisans were affected by the system glitch.


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