Physician practices and other providers who serve Medicaid beneficiaries can help patients retain health insurance coverage by encouraging them to respond promptly to recent requests from the Arkansas Department of Human Services (DHS) for income verification. Many beneficiaries have or will soon lose their health insurance for one simple reason: they have failed to respond to DHS’ request for proof of income to determine eligibility for Medicaid.

DHS is conducting a review of beneficiaries’ income to establish continued eligibility for enrollees in traditional Medicaid and ARKids First, and the first annual renewal for the Private Option (Arkansas’ Medicaid expansion program). Every person who has had coverage through one of these programs for at least a year is subject to an eligibility redetermination. If he or she (or the parent/guardian of an ARKids First child) receives mail from DHS requesting information, encourage him or her to respond fully and promptly to keep Medicaid coverage, and in some cases, to keep you as their physician. Losing coverage also means losing medication coverage. Many beneficiaries may not even be aware they have lost insurance coverage until they try to refill a prescription or need other health care services.

On Aug. 27, the Centers for Medicare & Medicaid Services (CMS) directed DHS to give Medicaid beneficiaries 30 days to provide proof of income. This policy change does not affect the people who had their coverage terminated Aug. 1 and Sept 1. DHS will stop sending termination notices temporarily while it adjusts its computer systems to reflect the new 30-day deadline.

If the requested information is not provided on time or DHS is delayed in processing the information, Private Option enrollees who have been terminated from Medicaid by DHS cannot keep their current insurance. They cannot automatically be placed back into the same insurance plan if they are later reinstated. They will have to pick a new insurance plan. A new plan could mean they will have to find different health care professionals who will accept their new insurance.

If your patients get a “request for information” from DHS, it will include instructions about how to proceed in one of two ways:

  • If the request is for proof of income, enrollees should mail a copy of that notice and a copy of a pay check stub, employment statement or award letter to:

DHS Pine Bluff Scanning Center
122 W. Sixth St.
Pine Bluff, AR 71611

  • If the request asks them to complete the renewal process online, enrollees should go to   Respond to the voter registration question with a “yes” or “no” and proceed to the next page. Click the yellow button that says Log in/Apply or Renew. Follow the prompts on the screen to complete.

Pay stubs or other proof of income are requested when the state’s Workforce Services department either has no income record for the beneficiary, or records show a change in income (that crosses an eligibility threshold) since the beneficiary was first approved for Medicaid.

Medicaid beneficiaries or Private Option enrollees who have lost their coverage because of DHS termination can have their coverage reinstated if they provide income verification within 90 days and they are still eligible for Medicaid or the Private Option. Coverage can be reinstated retroactively to the date of termination, but only if the documentation is submitted within 90 days, according to DHS.

COVERAGE NOTICE: Beneficiaries who have had their coverage terminated and were covered by Arkansas Blue Cross & Blue Shield OR Ambetter of Arkansas WILL HAVE 30 days of prescriptions paid. In addition, any provider claims will be held for 30 days. If the beneficiary is not reinstated within 30 days, the claims will not be paid.

POST CORRECTED 9-1-15; 9:15 a.m.