Supporting Public Health Emergency (PHE) Unwinding in Kentucky


At the start of the Covid-19 pandemic, Congress enacted a requirement to keep individuals continuously enrolled in Medicaid programs until the end of the public health emergency (PHE). Bolstered by this requirement, enhanced federal funding, and increased flexibilities, the number of Medicaid beneficiaries in states grew substantially. With the end of the PHE, states were tasked with developing and implementing plans to ensure eligible beneficiaries continue to receive coverage, while those who are no longer eligible transition to other health plans.

Understanding the need to get ahead of the PHE unwinding and Medicaid renewals early on, Medicaid leaders in Kentucky turned to Altarum in the summer of 2022 for policy expertise and expanded implementation capacity. Altarum has since supported the planning and operationalization of all elements of the PHE unwinding for the state, with a focus on the resumption of Medicaid renewals.


With Altarum’s operational support, Kentucky remains in compliance with federal requirements by tracking activities, taking state actions necessary to request and receive approval for system changes, broadly coordinating across all PHE unwinding stakeholders, providing high-touch strategic support across all sister agencies and system contractors, and conducting ongoing monitoring of upcoming needs or anticipated concerns. 

Here are examples of how Altarum is working to ensure Kentucky is supporting all Medicaid members and complying with all Centers for Medicare & Medicaid Services (CMS) requirements to receive a full Federal Medical Assistance Percentage (FMAP) enhancement:

  • Tracking progress of all system changes and their implementation requirements.
  • Conducting daily (initially), and now thrice weekly, full sister agency coordination meetings to bring all parties to the discussion.
  • Performing detailed data monitoring and termination reason investigation to support necessary adjustments.
  • Maintaining a high level of communication across all stakeholders and with Medicaid members.
  • Providing support and facilitation of public presentations and meetings to inform on updates and evolving strategies.
  • Delivering detailed tracking of all flexibilities implemented during the pandemic and their long-term impact or permanent implementation.
  • Providing support in securing appropriate federal approval for waivers and flexibilities that are evolving.
  • Coordinating across long term services and supports (LTSS) teams to support home and community based (HCB) programs, waiver participants, and waiver providers.
  • Supporting over 65+ DMS leadership speaking engagements.


With the support of Altarum, Kentucky DMS has elected to act on 100% of proposed state strategies from CMS to streamline Medicaid renewals applying to Kentucky Medicaid/KCHIP. Of note, the state is also in full compliance with CMS expectations for making ex parte renewals at the individual level. These are one of the strongest tools available to states to keep eligible individuals enrolled in Medicaid or Children’s Health Insurance Program (CHIP) coverage, all while lessening the burden on enrollees.

Due to key strategies implemented, Kentucky is in full compliance, including ex parte renewals and continuous coverage for children, and is receiving the maximum amount of FMAP enhancement 
from CMS. 


Helen Dawson
Project Manager
Krissy Azeem
Senior Director, Delivery System Transformation