Medicaid eligibility checks resume April 1, 2023
We had been anticipating an announcement from the federal government about the end of the COVID-19 Public Health Emergency (PHE). Late in 2022, we began to hear that Congress might separate the Medicaid continuous enrollment requirement from the ongoing PHE – and they in fact did so in late December, in the omnibus spending bill signed into law by President Biden on December 29, 2022. As a result, while the PHE continues, states are now required to resume Medicaid eligibility processes beginning April 1, 2023.
We are anticipating guidance from the federal Centers for Medicare & Medicaid Services in early January, and we will be prepared to share an update with you at our February 1 meeting of the Medical Assistance Advisory Council. We will also be updating our StayCoveredNJ website, removing references to the end of the PHE and clearly stating the April 1 date for when eligibility processes will resume. Please visit our Community Toolkit page for posters in English, Spanish, and 19 other languages.
In the meantime, here are the two most important things for our NJ FamilyCare members to know:
Make sure NJ FamilyCare/Medicaid has your correct mailing address
Members can confirm or update their contact information by calling NJ FamilyCare at 1-800-701-0710 (TTY: 711). NJ FamilyCare will use this information to communicate with members about their healthcare coverage.
Respond to mail from NJ FamilyCare/Medicaid
Members need to look for and respond to mail from the State of New Jersey or their local County Board of Social Services. If NJ FamilyCare requests information, they need to respond right away to avoid a gap in their NJ FamilyCare coverage.
Paying a family member/employee for services while individual is out of state.
Regardless of relationship to the individual receiving services, the employee hired by the provider agency as a DSP would be able to provide the service. Any service would continue to require applicable service documentation.
As you mention extended periods of time, should an individual plan to be out of NJ for an extended period of time, the individual/family would need to write a letter to Medicaid requesting to keep their Medicaid intact while they are out of state. The letter needs to indicate the date they are leaving, expected length of time they will be out of state, and expected return date. Otherwise, their Medicaid may be terminated – in which case no services will be funded.
If the individual/family requests and is granted approval from Medicaid to keep their Medicaid intact while they are out of state, then specific services can continue in the out-of-state setting for the period of time approved by Medicaid. Out-of-state providers would be unable to provide a service, regardless of the provider’s status as a Medicaid provider.
Medicaid contacts to send the letter are as follows:
• For individual enrolled in CCP: Brian Brennan: Brian.Brennan@dhs.nj.gov
• For individual enrolled in SP: Dena Charbonneau: Dena.Charbonneau@dhs.nj.gov