In response to the COVID-19 pandemic, Congress passed the Families First Coronavirus Response Act in March 2020. Federal guidance resulting from the Act instructed state agencies to maintain the same “amount, duration, and scope” of Medicaid coverage for recipients. This resulted in a moratorium on adverse action against existing recipients for nursing facility or waiver coverage. This led to the Family and Social Services Administration (FSSA), the Indiana state agency administering Medicaid benefits for Indiana residents, pausing all increases in monthly liabilities, the amount that Medicaid health coverage recipients must pay toward their care each month. This has created issues for recipients as their monthly income has increased without a matching increase in their monthly liability.
The FSSA has recently announced that it will be returning to the standard rules for the calculation of monthly liabilities on March 1, 2021.
Due to the suspension of adverse actions during the moratorium, this is likely to result in adjustments to the monthly liability for the vast majority of Medicaid health coverage recipients in nursing facilities and on waivers.
The FSSA has explained that this change is intended to limit the risk of a recipient being over the resource limit at the end of the public health emergency. Around the start of February 2021, Medicaid recipients can expect to begin seeing notices with updated liability amounts. It will be important to review these notices carefully to be certain that they are correct and that any necessary updates are made as soon as possible. These updated liability amounts are to be prospective only. Recipients should take care to avoid disruptions in eligibility or unpaid caregiver bills.
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