Covering Kids & Families of Indiana Newsletter |
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Senator Responds to Rogue Marketplace Brokers
Sen. Ron Wyden (D-Ore.) wrote to Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure that “federal regulators should use their statutory authority to fine rogue brokers and agents who sign people up for exchange plans without their knowledge. I write to express my outrage with reports that agents and brokers are submitting plan changes and enrollments in the federal marketplace without the consent of the people who rely on these plans. These plan changes and enrollments result in tangible harm to people, including uncovered medical expenses, loss of coverage and disruptions in care, and an unexpected tax liability that could be thousands of dollars out of their own pockets.”
Wyden, chair of the Senate Finance Committee, said he plans to introduce legislation that allows federal regulators to hold sellers criminally responsible for improper exchange plan sign-ups and switches. The Affordable Care Act already gives CMS the authority to fine misleading marketers up to $250,000, but the agency has not used that authority.
In a statement this month, CMS said it was considering issuing civil monetary penalties for unscrupulous agents and brokers in response to a rise in reports of people being enrolled in unauthorized policies. During the first three months of the year, CMS said it received approximately 40,000 complaints from people who had unknowingly been switched to new exchange plan policies, and an additional 50,000 complaints of unauthorized enrollments during the annual sign-up period for 2024. Regulators said they have worked to resolve almost all of these complaints and canceled members’ enrollments, reimbursed them for claims costs incurred, and sent consumers’ updated financial information to the Internal Revenue Service.
Consumers who believe they may have been a victim of unauthorized agent or broker activity associated with a Marketplace plan should call the Marketplace Call Center at
1-800-318-2596. Assisters can also report cases through the Complex Case web form or by calling the Marketplace Call Center. Consumers are also encouraged to file a complaint with the Indiana Department of Insurance.
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Good News in Environmental Health
The EPA's proposed interim decision (PID) canceled all but one use of the pesticide acephate. This decision is based on EPA's updated human health draft risk assessment (HH DRA) and drinking water assessment (DWA) that were released last year, which showed significant dietary risks from drinking water that contained acephate under previous registered uses. EPA also identified worker, homeowner, and ecological risks that would be mitigated by the proposed cancellations.
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NEWS FROM THE INDIANA SCHOOL HEALTH NETWORK |
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ISHN Conference Platinum Sponsor: |
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About CareSource Indiana
CareSource, a nonprofit managed care entity, serves Hoosiers with health insurance through the Healthy Indiana Plan, Hoosier Healthwise and Health Insurance Marketplace. CareSource has launched innovative programs including the CareSource Re-entry Program™ to ensure the successful transition of justice-involved individuals back into communities, as well as initiatives to remove barriers to social determinants of health, maternal and infant health and improve health equity.
Thank you CareSource for being a Platinum Sponsor of the 2024 Indiana School Health Network Conference!
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May is Foster Youth Month
May is Foster Care Month to acknowledge foster parents, foster children, volunteers, child welfare professionals, and community members who help ensure Hoosier children are safe, supported and loved. Last fall, the Indiana Department of Child Services (DCS) launched EVERY CHILD INDIANA to support foster families and recruit new ones.
In Indiana, 17% of children entering foster care are 14 to 18 years old. The DCS’ Older Youth Initiative offers services, support, resources, education, employment assistance and help with car insurance to assist youth in transitioning to life on their own. Former foster care children enrolled in Medicaid in any state on their 18th birthday are eligible for Medicaid until they are 26 without an income or asset test and no redeterminations (Policy Manual 2035.30.20). Their coverage will be under Hoosier Healthwise Package A or Hoosier Care Connect. Note: Prior to January of 2023, youth had to live in Indiana on their 18th birthday to be eligible for these benefits.
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Changes to Eligibility Regulations
Federal changes to eligibility regulations published on April 2nd by the Centers for Medicare and Medicaid Services (CMS) should help more people get enrolled and keep healthcare coverage. A recent blog by The Commonwealth Fund explains these changes and how lessons learned during the unwinding contributed.
Please note: Specific details about implementation in Indiana are not yet available.
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Updating address information: Makes permanent best practices from the unwinding such as using addresses verified by the United States Postal Service (USPS) and last known contact information from managed care plans. It also outlines actions states must take to respond to returned mail. States must be in compliance by December 2025.
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Timelines for responding to requests for information: Individuals must have at least 15 days to respond to requests when applying and 30 days to report a change. A 30 day minimum period already exists for renewals. States must be in compliance by June 2027.
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Making enrollment processes the same for different groups: Expands modernized and streamlined processes for people who are older and/or disabled. They must be able to submit applications in person, on-line, by telephone, or by mail. An in-person interview cannot be required. Also, renewals cannot be more frequent than once every 12 months and states must attempt to renew coverage by reviewing data sources before requesting documentation. States must be in compliance by June 2027.
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Removing barriers to CHIP coverage: This change eliminates waiting periods for children transitioning from private group health plans (such as employer coverage) to the Children’s Health Insurance Program (CHIP – known as Hoosier Healthwise Package C in Indiana). Also, states will no longer be able to require payment of past due premiums as a condition of reenrollment. Currently in Indiana, children can be “locked out” of CHIP for up to 90 days for nonpayment. Outstanding premiums must be paid prior to enrollment, or the child can reapply after the 90 day “lock out” period has passed. (Policy Manual 2035.32.00). States must be in compliance by June 2025.
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Cost Sharing Returns
Indiana Health Coverage Programs (IHCP), aka Medicaid, will return to cost sharing on July 1st and is expected to impact one million Hoosiers.
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Certain HIP (HIP Basic, HIP State Plan Basic, HIP State Plan Plus Copay) and CHIP (Hoosier Healthwise Package C) members will owe copayments to providers for some services starting July 1st.
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As announced in a previous Bulletin (8/17/2023), HIP and CHIP are the only programs reinstating copayments. Copayments are no longer required under any other IHCP programs.
- Invoices will be sent in July for August benefits for current members with premiums and contributions (HIP, Hoosier Healthwise Package C, MED Works).
- Most new applicants for these programs will need to make a first payment for their coverage to be activated.
- Cost sharing obligations are capped at 5% of family income with calculations made on a quarterly basis for HIP and MED Works and annually for Hoosier Healthwise Package C.
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SNAP EBT Cards
Electronic Benefit Transfer (EBT) cards with Supplemental Nutrition Assistance Program (SNAP) benefits have been subject to fraudulent use via cyber theft for some time. Indiana has implemented a card lock/unlock feature for EBT cards so that EBT cardholders can lock the card when not in use, preventing anyone from using the benefit. This function is accessed via the ConnectEBT website. This is an EBT function, therefore the DFR customer service number cannot answer questions about this functionality.
To lock a card:
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Go to www.connectebt.com/inebtclient
- Create an account if you do not have one, OR, log in with your user ID and Password
- Click on “Lock/Unlock” within the portal
- Select “lock my card everywhere” or “lock my card outside of Indiana” then click SUBMIT
To unlock a card:
- Follow the login steps above
- Click on “Lock/Unlock” within the portal
- Select “unlock my card”
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Limited health literacy contributes to poor health outcomes, greater costs, and even higher mortality rates. Disproportionately impacting marginalized populations, limited health literacy can exacerbate existing health and health care disparities, as well.
These fact sheets can help stakeholders understand, assess, and improve health literacy practices, including practical strategies to enhance written communications, interactions between patients and providers, and systemwide practices. A new infographic highlights the importance of health literacy and key improvement steps at the organizational level.
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Environmental Pollutants Resource
Do you have questions about drinking water contamination with lead? Do you need information about how to assess your mercury exposure from fish? Do you know and understand about PFAS chemicals?
The Great Lakes Center for Reproductive and Children’s Environmental Health can provide these answers . The mission of the center is to provide education and outreach to parents, schools, healthcare providers, and healthcare organizations like non-profits and departments of health on the adverse outcomes from exposure to environmental pollutants.
- Dr. Susan Buchanan
Great Lakes Center for Reproductive and Children's Environmental Health
Keynote speaker at ISHN 2023
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Healthy Spaces Happy Children
The Healthy Spaces Happy Children Pilot Program started in December 2023 with the goal to help childcare providers make their spaces asthma friendly. If you are interested in this program or know a childcare provider who may be interested, please share this link with them.
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IHCP Enrollment
Total Membership decreased in April.
With 1,990,822 members, there were 3,718, or -0.19%, fewer members in April 2024 than in March 2024.
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© 2023 Covering Kids & Families of Indiana | All Rights Reserved |
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