CMS Approves Plan to Trim FL Medicaid Retroactive Eligibility

Last month, the Centers for Medicare & Medicaid Services (CMS) approved changes to retroactive Medicaid eligibility (RME) proposed by the Florida legislature. The change will limit access to healthcare for those who are Medicaid eligible yet aren't enrolled.

Floridians now have up to 30 days of retroactive eligibility once they qualify for Medicaid, as opposed to the original 90 days. The 30-day policy will go into effect Feb. 1 and remain in place until June 30 unless state lawmakers vote to extend the change.

Earlier this year, the Florida legislature and former Governor Rick Scott voted to eliminate the three-month RME period for non-pregnant adults over 21. Under this plan, pregnant women and children are still eligible for 90 days of coverage, but it leaves three critical groups of people vulnerable to medical debt and bankruptcy: seniors, adults with disabilities and parents taking care of minor children.

Parents, seniors, and adults with disabilities would only have coverage going back to the first day of the month that the person applies. If an eligible parent or senior files on March 28th, Medicaid would only pay for coverage going back to March 1st. If an application is filed on March 4th, Medicaid will still only cover expenses up to March 1st.

In the letter giving the state approval, Seema Verma, CMS administrator, acknowledged the comments that were sent in opposition but wrote the state would be required to have a “robust outreach and communication strategy” with providers and beneficiaries that would also be posted on the website.

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