FCC Allows Use of Automated Calls, Texts for Coverage, Enrollment Info

The Federal Communications Commission (FCC) has issued guidance allowing federal and state governmental agencies to send automated calls and text messages providing individuals with information about retaining their enrollment in government healthcare programs.

The declaratory ruling responds to a letter from US Department of Health and Human Services (HHS) Secretary Xavier Becerra, in which the department asked for clarification about which types of calls and text messages were permissible under the Telephone Consumer Protection Act (TCPA).

HHS wanted to utilize text messages and automated, pre-recorded calls to help individuals maintain their health insurance coverage by encouraging them to follow up with their state Medicaid program, Children’s Health Insurance Program (CHIP), Basic Health Program (BHP), or health insurance marketplace.

Specifically, HHS brought attention to the Medicaid continuous enrollment requirement tied to the COVID-19 public health emergency (PHE). After the PHE expires, states will resume eligibility determinations, which may lead to millions of beneficiaries losing Medicaid coverage.

HHS asserted that these coverage losses might be avoided if state government agencies and their partners could communicate with beneficiaries through automated calls and text messages about how to retain health insurance coverage.

FCC’s guidance concurred with this reasoning.

“A critical component of the nation’s efforts to address the COVID-19 pandemic is the ability of governmental agencies to communicate effectively with the public,” FCC wrote.

“As states resume routine renewals and other eligibility actions relating to governmental health care programs, their ability to communicate with Medicaid, CHIP, and BHP enrollees will be critical to successful retention of healthcare coverage for eligible enrollees.”

Under the TCPA, “any person” making robocalls must obtain the recipient’s prior express consent before making the call. In the declaratory ruling, FCC agreed with HHS that a consumer providing their telephone number when applying for coverage through a government healthcare program constitutes prior express consent to be contacted at that number about enrollment eligibility.

In addition, FCC had previously clarified that federal or state government agencies that make pre-recorded voice or artificial voice calls or send auto-dialed text messages do not fall under the definition of “person” in the TCPA regulations. Therefore, their calls and texts do not require prior express consent.

The FCC guidance confirmed that HHS could direct federal and state government agencies to contact individuals about their health insurance enrollment regardless of if they initially provided a phone number when applying for coverage.

However, FCC emphasized that it will continue to monitor complaints about fraudulent text messages and calls relating to healthcare coverage and enforce rules when necessary.

In circumstances where calls and texts to wireless phone numbers would violate the TCPA, the guidance offered other strategies agencies can use to contact beneficiaries. Agencies can make calls to residential telephone lines or use live operators rather than pre-recorded messages. They can also contact individuals by email or direct mail.

Communicating with beneficiaries about Medicaid renewals is especially important as many may be unaware of the upcoming changes. Data from Urban Institute found that 62 percent of adults who are enrolled in or have a family member enrolled in Medicaid had heard nothing about returning to regular Medicaid renewals after the PHE ends.

The Alliance of Community Health Plans (ACHP) offered recommendations to CMS on how to streamline Medicaid and CHIP processes when the PHE ends.

CMS should work with Medicaid managed care plans to help support beneficiaries during coverage renewal, redetermination, and transitions to marketplace coverage. ACHP also noted the importance of creating a single application for Modified Adjusted Gross Income (MAGI) and non-MAGI beneficiaries.

Additionally, CMS could leverage third-party data to help inform Medicaid agencies about address changes, state income taxes, and supplemental nutrition assistance program (SNAP) utilization.