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Request for Information (RFI): Access to Coverage and Care in Medicaid & CHIP
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* Federal Policy Guidance
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* 1. Innovation Accelerator Program
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* American Recovery & Reinvestment Act
* Tribal Affairs Guidance & Resources
* Outreach Tools
* Outreach Tools
* Supporting Enrollment Efforts
* Helping Connect Enrollees to Care
* Living Well
* Quality of Care
* Quality of Care
* Medicaid Managed Care
* Improvement Initiatives
* Performance Measurement
* Releases & Announcements
* Enrollment Strategies
* Enrollment Strategies
* Continuous Eligibility
* Express Lane Eligibility
* Lawfully Residing Immigrant Children & Pregnant Women
* Presumptive Eligibility
* Home & Community Based Services
* Home & Community Based Services
* Home & Community Based Services Authorities
* HCBS Training
* Guidance
* Statewide Transition Plans
* Technical Assistance
* Program Information
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* Section 1115 Demonstrations
* About 1115 Demonstrations
* How States Apply
* Transparency
* 1115 Demonstration Monitoring & Evaluation
* State Waivers List
* 1115 Substance Use Disorder Demonstrations
* Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations
* Managed Care
* Managed Care
* Managed Care Authorities
* Enrollment Report
* Managed Care Entities
* Guidance
* Managed LTSS
* Profiles & Program Features
* Technical Assistance
* Eligibility
* Eligibility
* Estate Recovery
* MAGI Conversion Plan
* Seniors & Medicare and Medicaid Enrollees
* Verification Plans
* Minimum Essential Coverage
* Spousal Impoverishment
* Medicaid Third Party Liability & Coordination of Benefits
* Medicaid Eligibility Quality Control Program
* Financial Management
* Financial Management
* Payment Limit Demonstrations
* Upper Payment Limit FAQs
* Disproportionate Share Hospitals
* Medicaid Administrative Claiming
* LTC Ombudsman Programs
* No Wrong Door
* Translation and Interpretation
* State Budget & Expenditure Reporting for Medicaid and CHIP
* Expenditure Reports MBES/CBES
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* Provider Preventable Conditions
* Actuarial Report on the Financial Outlook for Medicaid
* Section 223 Demonstration Program to Improve Community Mental Health
Services
* Data & Systems
* Data & Systems
* Medicaid Enterprise Systems Newsletter
* MACBIS
* Medicaid Information Technology Architecture
* Medicaid Management Information System
* Medicaid Enterprise Certification Toolkit
* Medicaid Eligibility & Enrollment Toolkit
* Medicaid Enterprise Reuse
* Health Information Technology
* Health Information Exchange
* IT Procurement Opportunities
* Outcomes-Based Certification
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* Benefits
* Alternative Benefit Plans
* Alternative Benefit Plan Eligibility
* Designing an Alternative Benefit Plan
* Autism Services
* Behavioral Health Services
* Parity
* Substance Use Disorders
* Children and Youth
* SUPPORT Act Innovative State Initiatives and Strategies
* SUPPORT Act Provider Capacity Demonstration
* State Planning Grants for Qualifying Community-Based Mobile Crisis
Intervention Services
* Dental Care
* Early and Periodic Screening, Diagnostic, and Treatment
* Vision and Hearing Screening Services for Children and Adolescents
* Lead Screening
* Hospice Benefits
* Mandatory & Optional Medicaid Benefits
* Prevention
* Telemedicine
* Prescription Drugs
* Prescription Drugs
* Branded Prescription Drug Fee Program
* Drug Utilization Review
* Federal Upper Limit
* Medicaid Drug Policy
* Medicaid Drug Rebate Program
* Pharmacy Pricing
* Program Releases
* Retail Price Survey
* State Drug Utilization Data
* State Prescription Drug Resources
* Long Term Services & Supports
* Long Term Services & Supports
* Health Homes
* Person-Centered Hospital Discharge Model
* Person-Centered Planning Grants
* State Profile Tool Grant
* Balancing Long Term Services & Supports
* Integrating Care
* Employment Initiatives
* Institutional Long Term Care
* Money Follows the Person
* PACE
* Alternatives to Psychiatric Residential Treatment Facilities
Demonstration
* Reports & Evaluations
* Self-Directed Services
* Testing Experience & Functional Tools demonstration
* Workforce Initiative
* CHIP
* CHIP
* Benefits
* Eligibility Standards
* Eligibility Standards
* Waiting Periods
* Cost Sharing
* Financing
* CHIPRA
* CHIPRA
* CHIPRA Awards & Performance Bonus
* CHIP State Program Information
* Reports & Evaluations
* CHIP Managed Care
* CHIP Quality & Performance
* Basic Health Program
* State Overviews
* State Overviews
* Scorecard
* Scorecard
* National Context
* State Health System Performance
* State Administrative Accountability
* Federal Administrative Accountability
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Navigation Breadcrumbs
1. Home
2. Resources for States
3. Coronavirus Disease 2019 (COVID-19)
4. Unwinding and Returning to Regular Operations after COVID-19
UNWINDING AND RETURNING TO REGULAR OPERATIONS AFTER COVID-19
The expiration of the continuous coverage requirement authorized by the Families
First Coronavirus Response Act (FFCRA) presents the single largest health
coverage transition event since the first open enrollment period of the
Affordable Care Act. As a condition of receiving a temporary 6.2 percentage
point Federal Medical Assistance Percentage (FMAP) increase under the FFCRA,
states have been required to maintain enrollment of nearly all Medicaid
enrollees. When the continuous coverage requirement expires, states will have up
to 12 months to return to normal eligibility and enrollment operations.
Additionally, many other temporary authorities adopted by states during the
COVID-19 public health emergency (PHE), including Section 1135 waivers and
disaster relief state plan amendments (SPAs), will expire at the end of the PHE,
and states will need to plan for a return to regular operations across their
programs. CMS will continue to update this page as additional tools and
resources are released.
Unwinding Guidance
* Promoting Continuity of Coverage and Distributing Eligibility and Enrollment
Workload in Medicaid, the Children’s Health Insurance Program (CHIP), and
Basic Health Program (BHP) Upon Conclusion of the COVID-19 Public Health
Emergency (PDF, 815.14 KB) (Posted 3/3/2022)
* Updated Guidance Related to Planning for the Resumption of Normal State
Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health
Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health
Emergency (Posted 8/13/2021)
* State Health Office Letter: Planning for the Resumption of Normal State
Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health
Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health
Emergency (Posted 12/22/2020)
Tools and Templates
* Medicaid and Children’s Health Insurance Program COVID-19 Health Emergency
Eligibility and Enrollment Pending Actions Resolution Planning Tool (Posted
1/15/2021 and updated 3/3/2022)
* General Transition Planning Tool for Restoring Regular Medicaid and
Children’s Health Insurance Program Operations after Conclusion of the
Coronavirus Disease 2019 Public Health Emergency (Posted 1/15/2021)
* Program Integrity Considerations for Restoring State Medicaid and Children’s
Health Insurance Program Operations Upon Conclusion of the COVID-19 Public
Health Emergency
* Risk Assessment Template - Word Version
* Risk Assessment Template - Excel Version
* Risk Assessment Tool Webinar
Communications Tools
* Medicaid and CHIP Continuous Enrollment Unwinding – Toolkit (English (PDF,
1.61 MB)) (Spanish (PDF, 1.94 MB))
* Medicaid Unwinding Toolkit Graphics (ZIP, 4.62 MB)
* Consumer Research on Unwinding Phase I: Preventing Churn (PDF, 259.21 KB)
Other Guidance and Resources
* Overview of Strategic Approach to Engaging Managed Care Plans to Maximize
Continuity of Coverage as States Resume Normal Eligibility and Enrollment
Operations (Posted 12/8/2021 and updated 3/3/2022)
* Strategies States and U.S. Territories Can Adopt to Maintain Coverage of
Eligible Individuals as they Return to Normal Operations (Posted 11/24/2021)
* Connecting Kids to Coverage: State Outreach, Enrollment and Retention
Strategies issue brief (Posted 11/24/2021)
* Ensuring Continuity of Coverage and Preventing Inappropriate Terminations –
Part 2 (Posted August 2021)
* Ensuring Continuity of Coverage and Preventing Inappropriate Terminations –
Part 1 (Posted July 2021)
* CIB: Medicaid and Children’s Health Insurance Program (CHIP) Renewal
Requirements (Posted 12/4/2020)
* CIB: Coordination of Eligibility and Enrollment between Medicaid, CHIP and
the Federally Facilitated Marketplace (FFM or “Marketplace”) (Posted
7/25/2016)
CMCS Medicaid and CHIP All State Calls
* February 22, 2022 All-State Call Presentation: CMS Office of Communications
consumer research on preventing churn during unwinding
* February 15, 2022 All-State Call Presentation: Sunsetting Medicaid and CHIP
disaster relief SPAs and section 1135 waivers and options for disaster relief
SPA provisions
* November 30, 2021 All-State Call Presentation: Strategies for retaining
eligible individuals and engaging managed care plans
* August 19, 2021 All-State Call Presentation: Overview of August 2021 State
Health Official Letter
* January 19, 2021 All-State Call Presentation: Overview of eligibility and
enrollment provisions in December 2020 State Health Official Letter
* January 7, 2021 All-State Call Presentation: Overview of December 2020 State
Health Official Letter
* June 16, 2020 All-State Call Presentation: Additional information on federal
requirements for retaining Medicaid state plan flexibilities
* Unwinding and Returning to Regular Operations after COVID-19
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