COLUMBIA, S.C. — After nearly three years in a public health emergency, the South Carolina Department of Health and Human Services (SCDHHS) is returning to pre-pandemic procedures for Medicaid. For some, that could mean a change in coverage.
SCDHHS is reinstating its eligibility checks, to determine who qualifies for Medicaid coverage.
Previously, because of the pandemic congress stopped all screening.
“At the end of last year, congress passed a different law that reinstated the state requirement to do that," said Jeff Leieritz with SCDHHS.
Leieritz said the state will be re-evaluating everyone on Medicaid, over the next year.
“Each month throughout the year, we will be sending out eligibility review information for our 1.3 million members to ensure they’re still eligible for the program," Leieritz said.
According to SCDHHS, 250,000 to 300,000 more people became eligible during the pandemic.
With the review back in place many of those people could lose coverage.
“It may be somebody was on Medicaid because they had a baby and their twelve-month post-partum is over and they may not be eligible through post-partum, but what we would want to make sure is that they gave their income and information to the agency because they may fit into another category," said Sue Berkowitz with SC Appleseed Justice Center, a legal advocacy group that helps people with getting medical coverage.
The reviews on eligibility go into effect April 1st.
SCDHHS will first attempt to renew individuals' Medicaid eligibility with information that is already available in the system. If continued eligibility is verified, the Medicaid member will be sent a "continuation of benefits" notice and will not receive an annual review form.
If SCDHHS cannot verify continued eligibility, the Medicaid member will be notified and sent an annual review form that must be completely filled out and returned within 60 days.
If the Medicaid member has a cell phone number on file, SCDHHS will send a series of text messages to that number to remind the member to return their review form if they have not done so already.
There will also be an option to upload a completed eligibility form online. The online tool will allow members to provide requested information from SCDHHS, report a change in income, return annual review forms or submit other documents. Instructions on how to use the upload tool are also on the site.