CHNWA works closely with state agencies to promote access to care and reduce the number of uninsured.  This work ranges from conversations and collaborations with state agencies to make administrative processes more efficient to feedback on program design.


Medicaid Plan Choice Update

Workaround for Medicaid plan choice available on HCA website. The process for In-Person Assisters (IPAs or Assisters) to help Medicaid clients choose a health plan at the time of enrollment is available on the Health Care Authority (HCA) website, see “Workaround Process for Medicaid Plan Choice Selection,” (forms – HCA 19-014). 

This manual process was developed because the new Healthplanfinder website, where all Medicaid applications are now entered, does not allow Medicaid clients to choose a health plan as it does for consumers of commercial insurance.  Medicaid clients completing the workaround process with an assister at the time of enrollment can save themselves and their provider time by choosing a health plan that allows them to continue seeing their provider for care.

Links to workaround forms:

Assisters may download these forms to their desktops or print them for easier access. HCA prefers that assisters submit plan choice enrollment information directly through ProviderOne, which can now be done the day after client enrollment.

Workaround provides individuals with a choice.  HCA has noted that at the start of December, they received an influx of enrollment forms - three times the amount they usually receive in one month (HCA asked that forms be held until November 29th). There has also been a noted increase in plan changes reported through ProviderOne.  HCA has devoted one full-time employee as an additional resource to process the paper enrollment forms.

Forms submitted without a ProviderOne ID have presented a challenge.  HCA asks that assisters include the ProviderOne ID on the enrollment form that they send via fax or mail so that client choice is not delayed in a manual process to match up the client in the system. Due to problems with the Healthplanfinder website, HCA reports that they are making efforts to match up forms that do not have a ProviderOne ID with paper applications to ensure that their plan choice is noted.

A permanent solution is needed. The manual workaround was developed to help individuals seeking choice until the Healthplanfinder website could be changed. While this workaround is helping some individuals, it is limited to only those with access to assisters and is administratively burdensome. A simple and streamlined process is essential.

What advocates are supporting:

  • Enhanced federal funding available to align Medicaid and Exchange consumer experience. The federal government will provide a 90 percent match to assist states in improving their Medicaid systems to accommodate the changes brought by the Affordable Care Act. This supplemental funding would allow Washington to enhance Healthplanfinder to enable Medicaid enrollees the same ability to choose their plan that Exchange consumers have at a cost to the state of $390,000.
     

For more information, contact Sylvia Gil: (206) 515-7969 or sylvia.gil@chnwa.org