Temporary FMAP and Continuous Medicaid Enrollment ending as of March 31, 2023
In a memo from Daniel Tsai, the Deputy Administrator and Director for the Centers for Medicare and Medicaid Services (CMS), dated January 27, 2023, it was shared that the continuous enrollment condition and availability of the temporary increase in the Federal Medical Assistance percentage (FMAP) that were enacted in response to pandemic relief would cease as of March 31, 2023. The Consolidated Appropriations Act, 2023 was enacted in late 2022 and covers these items. For the purposes of this newsletter, we will focus on the two most pressing items for school districts in Texas to understand in order to account for and anticipate the changes.
1) The FMAP was temporarily increased during the Covid-19 pandemic under section 6008 of the Families First Coronavirus Response Act (FFCRA). This temporary increase was meant to help mitigate the loss in reimbursement districts would incur when students were not able to be in school due to the pandemic. For the FY2020 year, the FMAP was increased to 67.09% (a 6.2% increase) while in the FY2021 year it was at 68.01% (a 6.2% increase).
The FMAP represents the percentage of a state's overall Medicaid costs that the federal government will reimburse for. Because the temporary increase is ceasing as of March 31, 2023 and the cost report is filed on April 1, 2023 questions arose regarding which FMAP would be utilized for the FY2022 cost report. In the memorandum from CMS, it states that section 6008 "...extends the availability of, the temporary FMAP increase beginning April 1, 2023, gradually phasing down the increase until December 31, 2023."
The chart below shows the anticipated amount of the FMAP increase that will be available in each quarter of the calendar year.
Q1: January 1-March 31, 2023: 6.2 percentage points
Q2: April 1-June 30, 2023: 5.0 percentage points
Q3: July 1-September 30, 2023: 2.5 percentage points
Q4: October 1-December 31, 2023: 1.5 percentage points
2) The continuous enrollment and coverage in Medicaid that was extended through the FFCRA will not extend past March 31, 2023. This enables states to terminate Medicaid enrollment of individuals who no longer meet Medicaid eligibility requirements. The result of this for school districts could be an increase in administrative efforts toward enrollment in Medicaid, which would increase the RMTS results for MAC related activities and could increase total district reimbursement available.
Currently, only 22% of districts who partner with MSB are enrolled in the MAC program. Based on MSB's analysis of these districts, we've identified the financial opportunity available to your district to be around 3% of the total revenue you receive in SHARS reimbursement annually.
If your district is interested in pursuing MAC as an opportunity, fill out this form today to discuss this opportunity and get MSB started on initiating your district's enrollment.
As districts are anticipating the ESSER funding cliff and evaluating what financial opportunities can mitigate it, it is crucial to look to the Medicaid to Schools program to identify if you are utilizing it to the full potential for your district. To evaluate your SHARS program, your Program Specialist can share a financial report and identify opportunity.
To stay up to date on National trends in Medicaid and educational sessions, follow events from the National Alliance for Medicaid in Education (NAME).
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