1. Washington Apple Health
WCOMO
Amy Johnson, Eligibility Policy and Service Delivery
December 5, 2014

3. Conversion of MAGI Medicaid
Even with efforts made by HCA, individuals continued to struggle to complete their conversion of health coverage into Healthplanfinder and the renewal rate was at 28%
Extension of renewals for 3 months
Sending of a 4th notification letter
Conversion letters mailed through 9/30/14
As of September 2014, the renewal rate has returned to pre-ACA levels

4. Apple Health (Medicaid) Renewals
For individuals receiving Apple Health MAGI Medicaid* through Healthplanfinder:
60 days prior to an Apple Health recipient’s renewal due date, the Healthplanfinder system captures the individual’s original application and determines whether he or she is eligible for auto-renewal
Individuals will be notified whether they have been auto-renewed or that they could not be auto-renewed and must complete a manual renewal
*MAGI Medicaid: Family, Children, Pregnancy and Adult medical programs

5. Auto-Renewal Vs. Manual
Data-match finds household under the Medicaid standard
No data-match found and 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

6. December Renewals Total Individuals Auto-Renewed % Require
Manual Renewal
241,775
148,453
62%
93,322
38%

7. Estimated Renewals
Roughly 56% of total MAGI Medicaid households up for renewal over a 4 month period (December – March)
Month
Total Assistance Units
December 2014
194,549
January 2015
88,133
February 2015
124,857
March 2015
73,471

8. Auto-Enrollment Waiver
1115 Waiver currently under development to auto-enroll individuals in the following programs:
ABD Cash/HEN
TANF Cash
Pending
Subpopulation of SNAP
An individual receiving ABD/HEN/TANF assistance would be auto-enrolled into MAGI-based health care coverage during an overnight batch process (similar to SSI process)

9. Hospital Presumptive Eligibility
As required under the ACA, the Health Care Authority (HCA) has established guidelines and standards for implementing the Hospital Presumptive Eligibility (HPE) program. HCA goals include:
Provide a pathway to regular Apple Health coverage
Expand Apple Health eligibility training on the Washington Healthplanfinder to hospital staff
Implement HPE as a safety net to ensure appropriate access to care by eligible populations
HPE training of hospital staff scheduled to begin in early January 2015.

10. Health Coverage Form 1095-B
Purpose: To report information to the IRS and about individuals who are covered by Minimal Essential Coverage (MEC).
Optional in 2014
Required for tax year 2015 (when filing in 2016)
More information related to the ACA:

11. Resource Information HCA Medicaid Expansion www.hca.wa.gov/hcr/me
Training & Education
HCA Community-based training
Resources & workarounds
Reference guides
Apple Health webinars
Apple Health outreach materials

12. Questions?