Medicaid coverage reinstated for procedural denials

Medicaid coverage has been reinstated for Nevadans who recently had their coverage end because they did not return their renewal documentation, which is known as a procedural denial.

Previously, when individuals failed to complete renewal documentation, they were automatically disenrolled from Medicaid. However, due to a change in federal direction on policy in August, the Division of Welfare and Supportive Services (DWSS) was able to reinstate coverage for approximately 114,000 individuals.

In late August, the federal Centers for Medicare and Medicaid Services (CMS) provided notice to states updating guidance on evaluating individuals for Medicaid eligibility as the Public Health Emergency has ended.

The updated information provided by the federal government requires DWSS to evaluate eligibility based on electronic data sources per individual and only require a renewal packet for those whose eligibility cannot be confirmed using electronic data sources.

Individuals whose Medicaid coverage was reinstated this week will receive a notice in the mail from DWSS. These individuals are encouraged to notify their medical providers to address any billing and payment concerns and to secure potential reimbursement of Medicaid-covered services.

Individuals enrolled in Medicaid are urged to visit Update My Address and provide their current contact information to ensure they receive and respond timely to communications regarding their enrollment.

For information on existing Medicaid cases or how to apply for Medicaid, visit Access Nevada.