A federal oversight panel is urging HHS to pause the Medicaid work and community engagement requirements for Arkansas, citing concerns about the number of residents losing coverage.
In a letter to the agency, the Medicaid and CHIP Payment and Access Commission warned that the state's requirements, the first implemented in the nation, "may not be structured" appropriately, as 8,462 individuals in the state have been kicked off the rolls and excluded from Medicaid coverage since this summer.
The commission said HHS should stop throwing people off the rolls "to make program adjustments to promote awareness, reporting and compliance."
It said it is also concerned about whether Arkansas and CMS will be able to interpret early experience and examine progress with evaluation goals, since an approved evaluation design was not in place when the requirements were implemented in June.
"The commission calls on HHS to invest the time necessary to establish mechanisms for effective evaluation and monitoring and ensure adequate lead time for implementation before approving other states to begin enforcement of requirements that might lead to beneficiary disenrollment or lockout," the commission stated.
In October, CMS approved Wisconsin's Section 1115 waiver to implement Medicaid work requirements. Indiana and New Hampshire also have received approval to initiate such requirements, and other states have pending requests.
CMS Administrator Seema Verma stood behind the requirements at the 2018 Medicaid Managed Care Summit in September, saying, "Some have argued that these [work requirement] demonstrations are unnecessary because nearly all Medicaid beneficiaries are already working. To that I say — great. Then this policy won't impact them, and in fact if you look at Arkansas, the vast majority of adults subject to the requirement were ultimately exempted from the monthly reporting requirement because of their steady employment."