New York's Medicaid Purge Is About to Start: What to Do

Since April, reportedly half-a-million people in less than a dozen states have lost Medicaid coverage, a direct result of a continuous enrollment provision enacted during the COVID-19 public health emergency coming to an end.

More specifically, in December 2022, Congress passed the Consolidated Appropriations Act, 2023, which ended continuous enrollment on March 31, 2023.

And now, New York is on the chopping block. The state’s Medicaid purge will begin June 30 and continue over 14 months, reports the Times-Union, with more than 9 million New Yorkers in need of renewing their eligibility or risk losing coverage.

Some Background on Medicaid

The state’s Office for People with Developmental Disabilities (OPWDD) provides most of its services through New York State’s Medicaid program, jointly funded by the federal and state governments. (OPWDD also oﬀers limited services with state funding.)

To access services and supports from OPWDD, you need to apply for available beneﬁt programs (like Medicaid) that help pay for the services you need.

Medicaid pays for the following OPWDD supports and services:

Home and Community-Based Services (HCBS) waiver services (i.e., most OPWDD services, such as respite, supported employment, community habilitation, day habilitation, and residential services);
children’s waiver services (for children up to age 18 who have severe medical needs and a developmental disability);
care coordination;
residential care;
additional health-related items and services (such as Article 16 clinic services).

How Do I Know If I Need to Recertify?

Here are some tips I’ve picked up. (But please make sure to check with a care coordinator, if you have one, or the state Medicaid office.)

First, it’s critical to make sure your contact information is up-to-date with the state Medicaid office. If you need to recertify you should automatically receive a Medicaid recertification package in the mail.

In general, those who receive SSI need to recertify on a yearly basis.

Also, you always need to recertify if there has been a change to one or more of the following:

Living arrangements;
income or other resources;
insurance;
and/or immigration or citizenship status.

You will need documentation of the change(s).

(Note: The Medicaid renewal process is not consistent across all states and Medicaid groups.)

How to Recertify

Here, again, are some tips, but please check what’s needed with an expert.

Carefully fill out all paperwork and make sure to include all needed documentation. The process is often time-sensitive, so be sure to make note of the deadline.

If you work with a care coordinator through a Care Management Organization, they should be able to walk you through the process and any questions you might have. I say “should” only because of how overwhelmed they are with cases, and how some new care managers (for those organizations lucky enough to find people to hire) are learning as they go.

Medicaid Recertification Workshops

I’ll list them as I find them. If you know of one, please contact me here. Here’s one in Manhattan, being held June 14.

Details

What: “Medicaid Renewal Process: What’s Required & Tips to Ensure You Maintain Your Medicaid” workshop, part of the free Annual Manhattan Family & Professional Resource Fair

Date: June 14, 2023

Time: The specific time is unclear. The fair is being held 9 a.m.-2 p.m. Please contact the Manhattan Developmental Disabilities Council (the contact leads to an email form; I have an email in and will update if I hear back).

Where: CUNY Graduate Center, 365 Fifth Ave., N.Y., N.Y.