CMS shuts down Indiana's request to 'lock out' Medicaid beneficiaries

The Centers for Medicare & Medicaid Services has turned down a request from Indiana lawmakers that would “lock out” Medicaid beneficiaries who fail to submit paperwork to renew their eligibility.

“Authorizing a lockout for individuals at any income level who do not complete their annual eligibility redetermination is not consistent with the objectives of the Medicaid program, which include ensuring access to affordable coverage,” wrote Vikki Wachino, director of the Center for Medicaid & CHIP Services.

Indiana officials submitted the request for the six-month lockout in April, noting the state already had a similar lockout provision in place for people above poverty who fail to pay into the state's health savings accounts.

“The lockout for redetermination is an essential component of the [Healthy Indiana Plan] policy framework that, along with other policies, encourages individuals to maintain health coverage and avoid coverage gaps that interrupt treatment and continuity of care,” wrote Tyler Ann McGuffee, insurance and healthcare policy director under Gov. Mike Pence (R).  “To date, this policy has proven effective, as recent program data indicates an estimated 95 percent of HIP members are compliant with the redetermination process.”

Expanding the lockout to apply to beneficiaries both above and below poverty would have resulted in 18,850 people losing Medicaid coverage each year, CMS said in its response to Indiana's request.  

State officials will continue to pursue the lockout, Modern Healthcare reported.