Posted in the Philadelphia Inquirer (http://articles.philly.com/2012-07-13/news/32649327_1_medicaid-rolls-eligibility-state-federal-health-insurance-program).
July 13, 2012|By Angela Couloumbis, Inquirer Harrisburg Bureau
HARRISBURG – Pennsylvania has dropped tens of thousands of people from its Medicaid rolls since last summer – and now the Obama administration wants to know if the state wrongly cut off those benefits.
The federal agency that oversees how states administer Medicaid sent a letter last month to the Department of Public Welfare saying initial data showed 130,000 people, including 89,000 children, had been dropped from state Medicaid rolls between August and January.
Those people were dropped, noted the federal Centers for Medicare and Medicaid Services, when DPW was struggling with a backlog, leaving it unable to sort through all the information people had submitted in efforts to qualify for the benefit.
The federal agency also said in its June 14 letter that DPW appeared to have not always correctly followed protocol in reviewing eligibility.
DPW spokeswoman Carey Miller said the department had been working closely with the federal government to assess active and closed cases. She said the department could not definitively say that people had not been wrongly dropped from Medicaid rolls.
“Errors can happen,” said Miller, “and if an error did happen, we would do anything we can to fix that.”
She added: “This is a very complex matter . . . and we are making sure that everything is running properly.”
In the letter, a federal Medicaid official wrote that it appeared DPW had closed a high number of cases over the last year for reasons such as “failure to provide information” or “failure to return renewal form.”
This was happening “when DPW has reported that it was unable to process within appropriate time frames all the information beneficiaries had submitted to verify their eligibility,” wrote Anne Marie Costello, the federal agency’s director of Medicaid eligibility.
Medicaid is the joint state-federal health insurance program for the poor and disabled.
The letter notes that federal officials met with Pennsylvania’s welfare department in April and that DPW said at the time that it would review 12,000 cases – including 3,000 involving pregnant women and newborns – to determine if any had been wrongly rejected.
Costello said DPW told federal officials it would have results “soon” – apparently, not quickly enough.