Washington Apple Health Washington Coalition of Medicaid Outreach Amy Johnson, Eligibility Policy and Service Delivery June 19, 2015

Washington Apple Health Agenda Enrollment and Renewals Update Medicaid Plan Selection Apple Health Updates Share Your Apple Health Story Resource and Contact Info

Enrollment and Renewals Update 3

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Apple Health MAGI Renewals Auto-Renewal: Automatic renewal after federal hub data-match  Data-match finds household under the Medicaid standard  No data-match found and household income on file under the Medicaid standard No additional information needed by recipient Recertified for twelve months Manual: Data-match finds household above Medicaid standard Individual must manually complete their renewal 5

Apple Health MAGI Renewal Rates Auto-Renewal –Averaging 67% monthly (Dec 2014 – July 2015) Total Renewed Timely –Averaging 85% monthly (Dec 2014 – May 2015) Total Renewed After 90 Day Period –Averaging 92% monthly (Dec 2014 – Feb 2015) 6

Estimated Renewals Estimated Renewals Renewals are ramping up again, with our largest workload coming in December through February 7 MonthTotal Assistance Units July ,974 August ,549 September ,434

Medicaid Plan Selection Medicaid Plan Selection 8

Apple Health Updates 31

Post-Eligibility Review Update Less than 20% of the Medicaid population requires a post-eligibility review (reported family income is under Medicaid standard, but data match finds the family income to be over the Medicaid standard) Currently focusing on families active on N01(Family coverage) and N05 (Adult coverage) HCA completing roughly 3000 reviews weekly 32

Post-Eligibility Review Update Current Results  48% of case are found to be correct;  16% are found incorrect; and  33% are already closed or failed to respond to a request for information New audit tool is in the works! Tool will decrease processing time and simplify process 33

AEM Process Update Training Training webinar delivered on 6/10 Covered updates for the AEM process for MAGI and Classic Medicaid Recorded webinar and presentation slides available HCA Training & Education web page: Significant decrease in processing time as of May

Medicaid as Secondary Coverage If you have private insurance and qualify for Apple Health (Medicaid): May pay co-pays, deductibles and services your insurance does not cover; Make sure your provider you visit takes both your private insurance and Apple Health Services card; Your doctor will bill your private insurance first, if not covered by your insurance, but it is covered by Apple Health, they will bill Apple Health for payment 35

HCA CSC Client Survey Coming in July 2015! The HCA Medical Assistance CSC (MACSC) and Medical Eligibility Determination Services (MEDS) toll-free lines will be starting a client survey in July. Will be offered to each caller Survey will be optional For those who agree to participate, the survey will be conducted at the end of the call 36

Share Your Apple Health Story 37

Share Your Apple Health Story Can you help? We’re looking for individuals in Washington whose lives have changed for the better because they have Washington Apple Health coverage under the new MAGI eligibility—families, children, pregnant women, and adults (especially younger adults). The Health Care Authority and the Health Benefit Exchange (which operates are working together to build a collection of these stories. 38

Share Your Apple Health Story With individuals’ permission, their testimonials could be featured on the Healthplanfinder or Health Care Authority website or in HCA’s printed materials, or their stories and photos could appear on the Health Benefit Exchange corporate site under “Share Your Story.” The first step for anyone who is willing to publicly share their experience is to fill out the “Share Your Story” form at story/. story/ 39

Resource & Contact Info 40

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Resource Information 42 HCA Medical Assistance Customer Service Center HCA Medical Eligibility Determination Services us/ContactUs.aspx Cross-Agency Customer Support Center Desk Aid:

Additional Medicaid Resources  HCA Training & Education Resources  Cross-agency Desk Aid r_referrals.pdf  HCA Community-Based Specialists _Contact.pdf  Questions? Contact Us 43

Questions? 44