Georgia announce $54M in new funding for Medicaid renewal efforts

ATLANTA– The Georgia Department of Community Health (DCH) and the Georgia Department of Human Services (DHS) jointly announced today that more than $54 million has been secured through the Governor’s Office of Planning and Budget to support ongoing Medicaid and PeachCare for Kids® redetermination processing as part of a new, short-term “surge” effort.

The funding will support the engagement of contracted staffing, process improvement, and financial support to state eligibility workers. Officials also announced the expansion of its Express Lane Eligibility, and implementation of 12 months of continuous eligibility and enrollment to help ensure access and continuity of coverage for children.

Critical surge funds will support the Division of Family & Children Services (DFCS) of DHS, which processes all eligibility reviews in collaboration with DCH as part of the federally mandated Medicaid redetermination process. DFCS is reviewing eligibility of a peak total of 2.8 million Medicaid members that began in April 2023 for completion by May 2024. These funds serve as a Georgia-specific solution to nationwide challenges with staffing and call volumes due to the fast-approaching deadline to complete Medicaid redetermination efforts.

“This allocation is key in helping the state streamline processes and add critical resources where they are needed most so we are more efficient in serving Georgia families and ensuring those who are eligible for Medicaid remain covered,” said Gov. Brian Kemp. “We are grateful for all of our caseworkers who have worked tirelessly throughout this federally initiated Medicaid redetermination process and look forward to the impact this strategic surge will have on their efforts and eligible Georgians.”

Project planning and implementation will commence in January 2024. Several key components of the surge effort include:

• Casework Staff Augmentation: To process the backlog of Medicaid renewals, a surge team of 99 contracted caseworkers will focus solely on assisting DFCS eligibility staff with Medicaid renewals through December 2024.

• Change Request Processing Team: A team of 55 contracted staff will be tasked to assist DFCS eligibility staff with handling Medicaid-only change requests.

• Overtime and Stipends: Since workload often exceeds capacity for Medicaid eligibility teams, overtime and stipends will be offered for DFCS eligibility workers to earn as a quick way to gain additional capacity.

• Call Center Support: With some vulnerable classes of assistance requiring additional outreach to prevent their cases from closing in error, contracted staff will perform outreach so DFCS teams can better focus on casework.

• Email Box Support: A contracted staff of 10 personnel will monitor and respond to Medicaid-related and general email requests sent to DFCS eligibility staff.

• Process Improvement: Processes will be reviewed to streamline task routing and technology will be implemented to assist key DFCS resources with responding to internal policy and other routine questions and tasks.

This funding was provided through the Governor’s Office of Planning and Budget by utilizing remaining American Rescue Plan Act funds.

“We will continue to enhance our services and programs and create opportunities for better outcomes for our Medicaid and PeachCare for Kids populations,” said DCH Commissioner Russel Carlson. “Redeterminations will continue to be a massive effort requiring innovative thinking, and we are committed to ensuring all members who are eligible have every opportunity to keep their coverage.”

Express Lane Eligibility Expansion

Georgia is expanding its Express Lane Eligibility (ELE) strategy to include Refugee Cash Assistance, ChildCare and Parent Services, and the Women, Infants, & Children programs. Georgia is already utilizing ELE for the Medicaid, SNAP, and TANF programs. Express Lane Eligibility permits states to rely on data such as income, household size, or other factors of eligibility from another program to facilitate expedited enrollment in Medicaid and PeachCare for Kids®.

This coordination effort will help ensure that children have a fast and simplified process for having their eligibility determined or renewed. Additionally, the state is in the process of transitioning ELE from an opt-in functionality to opt-out functionality within the Georgia Gateway system to ensure that more individuals who are eligible for these programs will become enrolled. This expansion is expected to go live in early 2024.

12 Months Continuous Coverage and Enrollment

Georgia is implementing 12 months of continuous eligibility and enrollment for children on Medicaid and PeachCare for Kids® in early 2024. This will help ensure access and continuity of coverage for children and aims to help reduce disruptions in coverage. It could also increase access for children to necessary screenings and Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefits they are entitled to under Medicaid. Other benefits of continuous coverage include providing financial security to families, reducing state and health plan administrative costs, and enabling the state to more effectively measure the quality of care children receive since continuous enrollment is a prerequisite for most health quality measures.

“Georgia’s families with Medicaid and PeachCare for Kids® deserve the highest quality of customer service so they can stay in control of their coverage and improve their own lives,” said DHS Commissioner Candice Broce. “Along with the Department of Community Health, we are committed to listening to our members and our community partners to constantly improve processes and become a model for other states to follow.