Managed care plans, states can now text Medicaid beneficiaries to warn of enrollment changes

Managed care plans and states can now deliver robocalls and texts Medicaid beneficiaries without fear of violating a federal law, a critical change as states face eligibility redeterminations in a few months. 

The Federal Communications Commission (FCC) released new guidance Tuesday on the change after getting a letter from the Department of Health and Human Services (HHS) back in April 2022. States and managed care plans face a looming April 1 deadline to start redetermining the eligibility of everyone on Medicaid.

FCC’s goal is to ensure that “millions of Americans can receive the information they need to maintain enrollment in Medicaid and other governmental healthcare programs to avoid losing healthcare coverage,” according to an agency release. 

The guidance said that states and partners that include local agencies and managed care plans can under certain circumstances use robocalls or automated texts to raise awareness of eligibility issues.

HHS wrote a letter to FCC in April 2022 asking for an exception to the federal anti-robocall law, noting that states and managed care plans have looked to automated robocalls and texts to remind beneficiaries to respond to requests from their local Medicaid agency. 

FCC’s guidance comes at a pivotal time for states and managed care plans. At the onset of the pandemic, the federal government agreed to boost the matching rate for Medicaid payments, but only if the state did not drop anyone off Medicaid’s rolls for the duration of the COVID-19 public health emergency.

The PHE remains in effect until later this year, but Congress included a provision in a spending bill late last year that allowed states to start eligibility redeterminations April 1. The provision also phased out the bump to the matching rate for the rest of the year.

States and managed care plans have been prepping for months for the redeterminations to start, and a key issue has been outreach to affected beneficiaries. 

It remains unclear whether future exceptions will be granted to the Telephone Consumer Protection Law, a 1991 statute that restricted the use of robocalls. 

Insurers have been pressing the FCC to expand a 2015 order that enabled healthcare auto-calls.