Cognosante’s Customer Experience Business Sector to Support CMS Enrollment Assistance Program for Medicaid Unwinding

Cognosante’s customer experience (CX) business sector, CognoConnected, has been awarded the Enrollment Assistance Program (EAP) for Medicaid Unwinding contract by the Centers for Medicare & Medicaid Services (CMS). The 19-month contract has an approximate value of $21 million.

Cognosante will support the CMS Center for Consumer Information and Insurance Oversight (CCIIO) in ensuring continuity of coverage for individuals and families impacted by the Medicaid Unwinding at the end of the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). Cognosante will provide outreach and impartial, free, in-person and virtual enrollment assistance to impacted consumers in multiple states, facilitating their seamless transition into a Qualified Health Plan (QHP) through the Federally Facilitated Marketplace (FFM).

Following the end of the PHE, states must conduct Medicaid and Children’s Health Insurance Program (CHIP) eligibility redeterminations for beneficiaries. Many beneficiaries have remained on Medicaid and CHIP throughout the COVID-19 pandemic due to the continuous enrollment condition authorized by the Families First Coronavirus Response Act (FFCRA). As a result, a large volume of beneficiaries across the country who are determined to no longer be eligible for Medicaid or CHIP, or fail to respond to the redetermination requests, could face a loss of health insurance coverage

To help these impacted consumers smoothly transition from Medicaid or CHIP to enrollment into QHPs – also referred to as Medicaid Unwinding – Cognosante will provide trained local support teams in designated states to help consumers and their families navigate the Healthcare.gov application process and make informed health coverage decisions. Cognosante will collaborate with local community organizations to maximize outreach efforts and engage directly with the enrolling community where they live and work.

According to CMS, Medicaid Unwinding presents the single largest health coverage transition since the first open enrollment period of the Affordable Care Act (ACA). “The Cognosante team will bring to bear the full depth and breadth of our customer experience expertise to support CMS’ mission of ensuring continuity of coverage for eligible consumers,” said Anita Griner, General Manager of Cognosante’s customer experience business sector.

Cognosante supported CMS in a similar EAP during implementation of the Affordable Care Act. In addition, Cognosante was recently awarded the CMS No Surprises Help Desk contract, which intends to protect individuals from surprise medical bills for emergency services, air ambulance services furnished by nonparticipating providers, and non-emergency services furnished by nonparticipating providers at participating facilities in certain circumstances.