About half the states aren’t accepting extra leeway from the federal government.
to prepare for a spike in coverage disputes during the unwinding process, including requests for fair hearings, during which beneficiaries can challenge the state’s decision before an administrative law judge. to help with the additional workload, but many states haven’t taken full advantage of the extra latitude.
The Health 202 analyzed recent unwinding reports submitted to CMS by 20 states that haven’t taken up the flexibility and found that at least 12 of them have a backlog of cases older than 90 days. While beneficiaries can request to have their benefits continue during the fair hearing process, the coverage termination notices sent by states don’t always make that clear. Plus, beneficiaries in those states risk having to repay Medicaid for services it covers if a judge finds the state’s disenrollment decision was appropriate.
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