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DHS outlines prerelease Medicaid coverage in 1115 waiver: 30 days of meds, one year of coverage for prioritized reentrants
Summary
Department officials described a Section 1115 waiver that allows Medicaid coverage to begin before release from incarceration for prioritized individuals, covering 90% of costs with federal funds and enabling warm handoffs to community care; the department estimates roughly 7,000 people would be assisted under the program.
HARRISBURG — The Department of Human Services described a Section 1115 Medicaid demonstration waiver that the department says will allow health coverage and prerelease care planning for certain people leaving incarceration.
Secretary Acush told the committee the waiver was approved late in 2024 and would allow Medicaid flexibility the state had not previously had. She said the federal match would cover about 90% of program costs with the state responsible for about 10%.
Nut graf: DHS said the program aims to reduce overdose deaths, emergency department use and recidivism by arranging medical appointments, medication and case management prior to release and maintaining one year of Medicaid coverage after release.
Under the plan, the department said caseworkers would begin working with prioritized individuals roughly 90 days before release, focusing first on people with serious mental illness, substance use disorder, serious chronic disease, and pregnant people. Officials estimated about 7,000 people would be assisted. The department said people would walk out of prison with doctors' appointments scheduled, 30 days of medication in hand, an identified primary care doctor and one year of Medicaid coverage.
Asked how services would continue, Acush described "warm handoffs" to community case management and said the 30 days of medication would be renewable through Medicaid during that year of coverage.
Ending: DHS characterized the waiver as a partnership with the Department of Corrections to support reentry outcomes and asked the legislature to consider funding details as implementation proceeds.
