Presumptive Medicaid extended anew

Because the federal government has yet to provide a two-month notice lifting the National Public Health Emergency that was put in place due to COVID-19, the Presumptive Medicaid Eligibility program will be extended again for another three months.

Commonwealth Healthcare Corp. CEO Esther Muña said in a press conference last week that the federal government has yet to provide its two-months’ notice officially lifting the National Public Health Emergency, that essentially extends the Presumptive Medicaid Eligibility program to April 2023.

“The [previous] extension was set to expire on Jan. 10. Because no two months’ notice was given, the government will have to extend the program another 90 days,” she said.

The Presumptive Medicaid program was established pursuant to the National Public Health Emergency put in place due to COVID-19. It offers immediate access to health care while applying for regular Medicaid or other health coverage. You can start using PE for Medicaid coverage right away for Medicaid-covered services, such as doctor visits, hospital care, and some prescription drugs.

Under the rule, a two-months’ notice should be given before the Public Health Emergency is lifted, thus ending the program.

However, Muña said the two months’ notice should have been given no later than November 2022. As a result, because ample time was not given, the program will be extended.

The program has been extended numerous times since its inception back in 2020.

Presumptive eligibility, or PE, is an expedited process of enrolling eligible residents in the CNMI Medicaid program. It allows patients to have their care covered while waiting for their application to be fully processed. Starting the day you are approved for PE, you are able to go to any health care provider that accepts Medicaid.

Individuals and families are eligible for Medicaid if their attested gross income does not exceed 180% of the Supplemental Security Income federal benefit, which is about $28,800 annually for a family of four.

Medicaid, under the Centers for Medicare & Medicaid Services, has already started the “unwinding down” process, which essentially means vetting all the applications for those who were presumed eligible for Medicaid and determining whether they really are eligible for regular Medicaid or not.