HCBS Medicaid recertification guide
- The Public Health Emergency (PHE) that was put into place in 2020 is ending 4/1/23. This means that participants will need to ensure they are completing all of their recertification paperwork for Medicaid prior to the recertification due date.
- The SC will use the PHE spreadsheet to see which participants they need to follow up with, to address the participant’s upcoming recertification date.
- The SC will use the following script to discuss the recertification process with all of the participants on the spreadsheet. Please cover all of the information in the script with the participant
- “I’m calling because once a year, the state needs to verify that you’re still eligible to receive Medical Assistance. In 2020, the Department of Human Services (DHS) put a hold on the process of closing Medical Assistance because of the pandemic, but this hold has now been lifted. Have you already provided the necessary information to the state to renew your Medical Assistance? If not, you should be receiving a renewal packet in the mail soon from DHS explaining how to renew your Medical Assistance. After that, if you still qualify for your current level of Medical Assistance, you can continue your current coverage through PA Health & Wellness. If you no longer qualify for Medical Assistance, your information will be securely transferred to Pennie, Pennsylvania’s official health insurance marketplace where you can explore PHW’s low-cost or no-cost options.Please can you write down the following information: If you do not receive the renewal packet or want to do your renewal now without having to wait for the packet to come, please go online to dhs.pa.gov/COMPASS and fill in the required information to renew or call 1-866-550-4355 to do your renewal with a representative over the phone. Do you have any questions about this process?”
- SC will then complete a “HCBS MA recertification” session in Function Portal, to document that the conversation with the participant took place and put the date the outreach took place in the “outreach attempt” column of the spreadsheet.
- The process will only be completed by one of the following:
- The participant’s recertification paperwork is completed with CAO
- The SC has had a successful contact and discussed the script with the participant OR the SC has made 3 outreach attempts to the participant and completed a “HCBS MA certification” session for each outreach.
- The first outreach is made 60 days prior to the recertification due date (should only be done on the “due date” indicated in the spreadsheet)
- The second outreach is made 30 days prior to the recertification due date (should only be done on the “due date” indicated in the spreadsheet)
- If the participant reaches out to the SC with any questions about what is due or if they did not get a recertification packet from the CAO, provide them with the following information.
- If they did not receive the renewal packet or they want to do the renewal now, without having to wait for the packet to come, they can go online to dhs.pa.gov/COMPASS and fill in the required information to renew or call 1-866-550-4355 to do the renewal with a representative over the phone.