WV MCO Launches Digital Tool to Help Members Meet Work Rules
Highmark Health Options West Virginia, one of the state's four Medicaid managed care organizations, is partnering with Fortuna Health to launch a digital platform helping its 20,000 members navigate new Medicaid work requirements and more frequent eligibility redeterminations starting in January. The "TurboTax for Medicaid" tool will provide renewal reminders via text, email and voice AI, guided navigation through redetermination, and multilingual live agent support, steering members to the state's PATH portal. HHO's CEO Jason Landers said he expects roughly 20% of eligible members to temporarily lose coverage due to administrative paperwork burdens, not ineligibility. The work requirements, created under the federal reconciliation law known as H.R. 1, will require most expansion adults aged 19-64 to work, train or volunteer 80 hours monthly, affecting an estimated 33,000 West Virginians statewide.