Delaware Extends Postpartum Medicaid Coverage to 12 months

NEW CASTLE (June 16, 2023) – The Delaware Department of Health and Social Services’ Division of Medicaid and Medical Assistance announces that it has extended Medicaid postpartum health care coverage from 60 days to 12 months after the end of a pregnancy.

This expansion is made possible through a State Plan Amendment approved by the Centers for Medicare and Medicaid Services (CMS) in May. The expansion is retroactively effective as of July 2022. Delaware is one of 35 states to extend Medicaid and Children’s Health Insurance Program (CHIP) coverage to 12 months following the end of pregnancy.

Previously, Medicaid enrollees who were pregnant received coverage through the end of the month in which their 60-day postpartum period ends. A provision in the American Rescue Plan Act in 2021 gave states the option to extend Medicaid postpartum coverage to 12 months. This provision was made permanent by the Consolidated Appropriations Act, which was signed into law by President Biden in December 2022.

Medicaid recipients will now be eligible to receive 12 months of ongoing postpartum health care coverage beginning on the date their pregnancy ends, regardless of the reason, through the last day of the month 12-months after the last date of the pregnancy. These individuals will remain eligible for ongoing postpartum health care coverage even if certain changes occur that may affect eligibility — such as a change in income or household/family unit.

“It is critical that families receive the necessary supports before, during and after pregnancy,” said DHSS Cabinet Secretary Molly Magarik. “By extending postpartum coverage to a full year, we can help ensure that Delaware mothers and babies have access to high-quality health care at a time when they may need it the most. This is an important step to reduce health disparities, improve long-term outcomes and build the foundation for a healthy life.”

In 2020, Medicaid covered 41% of births in Delaware, according to data from the Division of Public Health’s Office of Vital Statistics. Medicaid covers a higher percentage of births from mothers of younger ages – 74% from those 20-years-old or younger and 51% from those 30-years-old or younger.

The Medicaid program finances about 4 in 10 births in the United States and more than half of all children in the country, according to data from CMS. An estimated 509,000 Americans across 35 states and the District of Columbia now have access to extended postpartum coverage.

For more information on Medicaid in Delaware visit https://www.dhss.delaware.gov/dss/medicaid.html. DHSS also reminds Medicaid recipients that annual eligibility renewals restarted April 1, 2023, and that they should make sure that Delaware Medicaid has their most up-to-date contact information. Members should also watch their mail for letters from Delaware Health and Social Services, fill out their renewal form if they receive one and return it immediately. For more information, visit de.gov/medicaidrenewals or call 1-866-843-7212.

Delaware Medicaid Annual Eligibility Renewals Underway

Medicaid renewals began April 1;

Members should verify contact information with DHSS, watch for renewal information

The Delaware Department of Health and Social Services (DHSS) has resumed the standard eligibility renewal process for Medicaid and CHIP recipients as of April 1, 2023, as required by federal law. Annual renewals were not required from March 2020 to March 2023 during the federal Public Health Emergency designation. Federal legislation, signed into law on December 29, 2022, set a specific date to resume renewals, regardless of when the Public Health Emergency ends.

As of January 2023, approximately 315,000 Delawareans were enrolled in Medicaid. With annual renewals underway, DHSS estimates 40,000 to 50,000 Delaware residents who were receiving continuous coverage due to the Public Health Emergency may no longer qualify for Medicaid or CHIP, also known as the Delaware Healthy Children Program, and may be disenrolled.

Between April 2023 and April 2024, DHSS is reviewing every member’s eligibility and, where approved by state or federal rules, using available data sources to automatically renew members. If DHSS cannot auto-renew a person’s coverage using available and approved data sources, the member will receive a pre-populated renewal letter by mail. Delaware Medicaid and its Managed Care Organization partners are also using texts, email, and social media when available to enhance outreach efforts.

A member can complete their renewal through a variety of ways: online through Delaware ASSIST, by phone, by mail, by fax, or at any Division of Social Services (DSS) office locations. Individuals who need assistance filling out their renewal can call the Division of Social Services Customer Service Unit at 1-866-843-7212.

“Over the past three years, the state’s public assistance programs have been a crucial safety net for so many Delawareans,” said Molly Magarik, Secretary of the Delaware Department of Health and Social Services (DHSS). “As we are undertaking the monumental task of restarting eligibility renewals again, our goal is to ensure Medicaid members who continue to be eligible stay enrolled and that those who are determined to no longer be eligible get connected to affordable coverage.”

The most important thing Medicaid and CHIP members can do is to update their mailing address, email and phone numbers with DMMA and sign up for electronic notifications. Contact the Change Report Center at (302) 571-4900, Option 2 or send changes via fax to (302) 571-4901. Changes and notification preferences can also be made at ASSIST Self Service https://assist.dhss.delaware.gov/. Individuals can find out more information about the renewal process at de.gov/medicaidrenewals.

“There are many Delaware residents who qualified for Medicaid coverage for the first time during the Public Health Emergency who have never had to complete an annual renewal before,” said Steven Costantino, Director of Health Care Reform for DHSS. “This is why it is critical that we have the most accurate information available for each member, and that individuals on Medicaid watch out for communication and take the necessary steps to renew. We do not want anyone who is eligible for Medicaid to be disenrolled.”

Health care providers and others who provide services to members can help by reminding their Medicaid members to look for and complete their Medicaid renewals this year and to encourage them to start exploring other coverage options if they believe they will no longer qualify for their current coverage.

Special Enrollment Period Authorized for Health Insurance Marketplace

To help individuals who are no longer eligible for Medicaid coverage, the federal government has authorized a Special Enrollment Period for the Health Insurance Marketplace. Individuals who lose their coverage through Medicaid and CHIP any time between March 31, 2023, and July 31, 2024, will be eligible for a marketplace special enrollment period. After a person is determined eligible for the marketplace, they will have 60 days to choose a plan, and their coverage will start the first day of the month after the plan is selected.

Many enrollees can find plans on the Health Insurance Marketplace that cost less than $10 a month. Plans cover services like prescription drugs, doctor visits, urgent care, hospital visits, and more.

Delawareans who no longer qualify for Medicaid should ensure that they do not experience a gap in health insurance coverage, but choosing the right private health insurance plan can seem daunting. Trinidad Navarro, the Commissioner of the Delaware Department of Insurance, suggests that a good first step would be to visit ChooseHealthDE.com to locate a local, federally registered/approved Navigator for assistance in enrolling in the Federally Facilitated Marketplace.

In Delaware, assistance enrolling in the Health Insurance Marketplace is available from certified Health Insurance Marketplace Navigator teams at Westside Family Healthcare and Quality Insights. To be connected to a trained Navigator, call:

Westside Family Healthcare: New Castle County: 302-472-8655, Kent or Sussex counties: 302-678-2205
Quality Insights: 1-844-238-1189

Some individuals who are found to be ineligible for Medicaid may be eligible for or already enrolled in Medicare. If that’s the case, the Department’s Delaware Medicare Assistance Bureau (DMAB) (302-674-7364) is ready to help with locating supplemental Medicare and Prescription coverage.

“Our DMAB team is friendly, knowledgeable and approachable, and they are always there to help older Delawareans get the best possible coverage to supplement their Medicare plans,” said Commissioner Navarro.

Be Aware of Potential Insurance Scams

Additionally, Commissioner Navarro pointed out that buyers should beware of offerings that say they are “plans” that are actually not health insurance.

“As a general rule, if an offer seems too good to be true — it probably is,” Commissioner Navarro said. “Please be careful when searching for insurance on the Internet as you may accidently access a website that looks like it is advertising health insurance when it actually is not.”

For example, buyers may receive aggressive advertising from discount plans or discount cards offering discounts on health care for a monthly fee. Another example is so called “health sharing” plans, which allow buyers to join a group or association that will take a participant’s monthly payments, put them in a savings account or trust with other participants’ money, and then help pay some of the participant’s health care costs, as needed. Neither of these “plans” are health insurance plans, and participants do not have the same protections as they would under major medical health insurance.

It has also been reported that scammers may be calling or texting individuals that receive Medicaid asking for money to help with the Medicaid renewal process. Scammers might pretend to be from a real organization or a government agency. They can use phone, text or email to try to steal money or something of value from you. If someone contacts you and requests money for help with your Medicaid renewal they are not a representative of DHSS. DHSS will never ask you for money or for your credit card information.

The Delaware Department of Justice also reminds residents to be extra diligent about telephone scams by:

Never agreeing to pay any fine or other money over the phone, including by purchasing a money order or gift card at a store and providing the number to someone over the phone or by email. Government agencies do not take payments this way.
Not answering calls from unknown numbers or unfamiliar persons. Scams can be “spoofed” to appear to be coming from a local number, even though the call is originating from out of state or overseas.
Hanging up on aggressive callers, particularly those who threaten arrest.

Consumers who believe they may have been scammed may call the Consumer Protection Unit’s toll-free Consumer Hotline at (800) 220-5424, or e-mail consumer.protection@delaware.gov. Consumers can also report scammers’ phone numbers to the National Do Not Call Registry and file complaints at www.donotcall.gov.

For more information about the Medicaid renewal process, visit de.gov/medicaidrenewals.

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Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

Delaware Medicaid Eligibility Annual Renewals to Resume April 1

Congress sets April 1, 2023, as Medicaid renewal start date; Members should verify contact information with DHSS

The Delaware Department of Health and Social Services (DHSS) will resume the standard eligibility renewal process for Medicaid and CHIP recipients starting April 1, 2023, as required by federal law. Annual renewals have not been required since March 2020 during the federal Public Health Emergency designation. Federal legislation, signed into law on December 29, 2022, set a specific date to resume renewals, regardless of when the Public Health Emergency ends.

As of January 2023, approximately 310,000 Delawareans were enrolled in Medicaid. Once annual renewals begin, there will be Delawareans who were receiving continuous coverage due to the Public Health Emergency that will no longer be eligible for Medicaid. DHSS estimates 40,000 to 50,000 Delaware residents may no longer qualify for Medicaid or CHIP, also known as the Delaware Healthy Children Program, and may be disenrolled.

“Over the past three years, the state’s public assistance programs have been a crucial safety net for so many Delawareans,” said Molly Magarik, Secretary of the Delaware Department of Health and Social Services (DHSS). “As we prepare for the monumental task of restarting eligibility renewals again, our goal is to ensure Medicaid members who continue to be eligible stay enrolled and that those who are determined to no longer be eligible get connected to affordable coverage.”

The most important thing Medicaid and CHIP members can do right now is to update their mailing address, email and phone numbers with DMMA and sign up for electronic notifications. Contact the Change Report Center at (302) 571-4900, Option 2 or send changes via fax to (302) 571-4901. Changes and notification preferences can also be made at ASSIST Self Service, https://assist.dhss.delaware.gov/.

Between April 2023 and April 2024, DHSS will review every member’s eligibility and, where approved by state or federal rules, use available data sources to automatically renew members. If DHSS cannot auto-renew a person’s coverage using available and approved data sources, the member will receive a renewal packet by mail or a notification by email, depending on the selected preference.

Delaware Medicaid and its Managed Care Organization partners will also use texts, email, and social media when available to enhance outreach efforts. A member will be able to complete the renewal packet through a variety of ways: Online, by phone, by mail, by fax, or at any Division of Social Services (DSS) office located within the Delaware State Service Centers.

Many enrollees can find plans on the Health Insurance Marketplace that cost less than $10 a month. Plans cover services like prescription drugs, doctor visits, urgent care, hospital visits, and more.

Assistance enrolling in the Delaware Health Insurance Marketplace is available from certified Health Insurance Marketplace Navigator teams at Westside Family Healthcare and Quality Insights. To be connected to a trained Navigator, call:

Westside Family Healthcare: New Castle County: 302-472-8655, Kent or Sussex counties: 302-678-2205
Quality Insights: 1-844-238-1189

For more information, visit de.gov/medicaidrenewals.

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Statement From Auditor McGuiness On Judge’s Ruling

DOVER, Delaware – Today, Delaware State Auditor Kathleen McGuiness released the following statement in response to the Memorandum Opinion and Order from the court confirming the Auditor’s Office’s power to conduct performance audits:

Judge Karsnitz released his decision in our court case with the Delaware Department of Health and Social Services (DHSS) regarding our requests to audit Medicaid spending. My office fought for nearly two years for access to information needed to conduct a performance audit set within the professional standards and guidelines of the U.S. Government Accountability Office. This audit sought to determine if DHSS’ Division of Medicaid and Medical Assistance (DMMA) complies with federal and state requirements, implements effective internal controls, and incorporates data integrity throughout the program.

Medicaid spending accounts for nearly 1/5 of the state’s annual budget, and Delawareans deserve to know if Medicaid is complying with state and federal requirements when spending these critical funds.

The Auditor’s Office regularly receives confidential data as part of our duties under Delaware Code, and the prior administration conducted a nearly identical performance audit of Medicaid eligibility in 2014. However, despite a history of conducting this work, my staff and I received significant pushback and delays that undermine the independent audit process in our state.

This performance audit was hindered by the Department of Justice (DOJ) and their insistence this audit was not within the Auditor’s scope of authority. My staff was forced to learn to draft a subpoena because the assigned attorney from the Department of Justice declined to provide my office legal representation on this matter. The DOJ initially refused to grant my office outside legal counsel forcing us to represent the office pro se.

I would like to thank Judge Karsnitz for his objective ruling confirming the scope of authority of the Auditor’s Office. I commend Governor John Carney for his judgement in granting the office independent outside legal counsel. I applaud the efforts of Luke Mette of Armstrong Teasdale LLP and his team for their outstanding legal expertise and presentation of the facts.

There’s been a lot of confusion about what this office does or should be doing, but this decision makes it clear; taxpayers deserve to know if they’re getting a fair deal from their state government, and Delawareans should know they have fighters on their side in the State Auditor’s Office working on their behalf for accountability no matter the resistance.

Read the Court’s Memorandum Opinion and Order here.

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Contact: Tori Parker, Deputy Auditor
tori.parker@delaware.gov

DHSS Announces Organizations Selected to Operate Medicaid Managed Care Program

NEW CASTLE (July 12, 2022) – The Department of Health and Social Services (DHSS) announced today that it has selected three companies to operate its Medicaid Managed Care Program.

DHSS’ Division of Medicaid and Medical Assistance (DMMA) will continue its MCO partnership with Highmark Health Options Blue Cross Blue Shield, which began in 2015, and with AmeriHealth Caritas, which began in 2018. In addition, DHSS announced its intent to contract with Centene’s Delaware First Health.

“We are pleased to reach agreement with Highmark, AmeriHealth and Centene to provide these vital services to the Medicaid members we serve,” DHSS Secretary Molly Magarik said. “These companies not only will offer more choice to our Medicaid members, but they also understand Delaware’s commitment to value-based care, and to the critical services that our Medicaid members need and deserve. We appreciate the commitment of Highmark, AmeriHealth and Centene to providing a connection to care and support that will help our Medicaid members achieve their optimal health.”

In 2017, Gov. John Carney signed House Joint Resolution 7, which gave DHSS the authority to develop health care spending and quality benchmarks. The spending benchmark – a spending target – is linked to the growth rate of Delaware’s economy and includes all health care spending, including through Medicaid, Medicare and commercial insurers. The quality benchmarks are established periodically to offer strategic goals to improve the health of Delawareans and the care they receive.

Delaware’s Medicaid program serves about 300,000 members. Division of Medicaid and Medical Assistance Director Steve Groff said members will receive information during the next several weeks about their options in choosing a new plan for 2023. Open enrollment will begin Oct. 1.