PHE Unwinding - LEA Quick Reference Guide

Quick Facts

• Public Health Emergency (PHE) will expire on 5/11/2023.
• Continuous coverage requirement ends as of 4/1/2023.
• Medicaid redeterminations begin on 4/1/2023.
• Redetermination timelines will vary by state. See map for details.
• Enhanced Federal Medical Assistance Percentage (FMAP) will begin to phase out, and fully expires 1/1/2024.
• It is estimated that between 5 – 14 million people could lose their Medicaid coverage.
• A reduced Medicaid eligibility rate will impact school-based Medicaid claiming reimbursements.
• Medicaid outreach is reimbursable via Medicaid Administrative Claiming (MAC) programs, as activities will be captured in Random Moment Time Study (RMTS), for LEAs that participate in MAC.

 

Next Steps

• Local Education Agency (LEA) point of contact: your State Medicaid Agency.
• Don’t wait! Update! Encourage enrollees to update their address. Undeliverable mail will be a significant challenge.
• Educate Medicaid and CHIP enrollees about the upcoming changes, using available toolkits:
  • CMS Toolkit.
  • AASA Educator Toolkit.
  • Georgetown CCF Toolkit.
  • Insure Kids Now Back to School Toolkit.
  • State-specific toolkits may also be available at the State Health & Value Strategies state toolkit repository, or on your State Medicaid Agency website.

Stay Informed

• NAME/CASE PHE Unwinding Webinar.
• Join the CMS National Stakeholder Calls. For more information about these calls, you may email: This email address is being protected from spambots. You need JavaScript enabled to view it.
• CMS resources.