As of Thursday morning, another 8,762 warning letters had been sent to Medicaid and private-option beneficiaries informing them that their health coverage will end Aug. 31 unless they verify their eligibility, an Arkansas Department of Human Services spokesman said.
The notices were sent after Gov. Asa Hutchinson on Tuesday directed such cancellations to resume after a pause he had ordered two weeks earlier. Hutchinson called for the break to give the Human Services Department time to catch up on processing pay stubs and other records submitted by recipients to prove their eligibility.
The notices sent since Tuesday raised to 58,423 the number of Medicaid recipients whose coverage has ended or is set to end as a result of checks that began in May.
The income reviews are being conducted on those who have been Medicaid or private-option recipients for at least a year and whose eligibility is governed by rules that went into effect Jan. 1, 2014, under the federal Patient Protection and Affordable Care Act.
Those eligibility checks were originally expected to begin last fall but were delayed because of difficulties the Human Services Department has encountered in replacing its 25-year-old electronic enrollment and eligibility-verification system. Officials say the new system is needed to verify income under the new rules.
By October, the Human Services Department expects to have started checking the incomes of about 600,000 recipients.
So far, the department has initiated checks on almost 392,000 recipients.
It has found 70,799 to be eligible, department spokesman Kate Luck said Thursday.
Of those whose coverage has been canceled or is set to end, 2,127 were found to be ineligible, and 56,296 failed to respond on time to notices from the department.
The notices give recipients 10 days from the day the notice is sent to provide pay stubs or other records proving they are still eligible.
Those who fail to provide the records within 20 days lose their insurance coverage.
If recipients subsequently provide the requested information within 90 days of their coverage termination, the coverage can be restored retroactively to the date it was canceled.
The coverage for 2,471 people has been reinstated, reducing the total who remain removed from the program at 55,952, Luck said.
Although the department has caught up on logging the pay stubs and other records, it still has a backlog of cases for which such information has been logged as received but a final eligibility determination hasn't been made, Director John Selig said.
The new termination notices aren't being sent out until the department is sure the recipient is ineligible or did not respond within the required time frame, Selig said.
"There's lots of paperwork we have, but none of those people are getting terminated until we have a chance to process it," Selig told the Health Reform Legislative Task Force on Thursday.
The department has told health care providers and legislators: "If there is someone who has returned information to us that we haven't processed yet, give us a call, let us know, and we'll pull them out of the queue and work them more quickly," he said.
John Stephen, a consultant to the task force, said federal law appears to require recipients to be given at least 30 days to respond to the Human Services Department's records requests.
Selig said that part of the law refers to a type of coverage renewal in which the department sends out a form that recipients must complete and return.
For requests for income records, the department gives recipients 10 days, he said.
Department officials speak at least once a week with officials with the federal Centers for Medicare and Medicaid Services, and those officials haven't raised concerns about the 10-day deadline, he said.
"We feel comfortable that what we're doing is allowable," Selig said.
Those who have been removed from the program or whose coverage is set to end include 47,152 enrollees in the private option.
Under that program, the state uses Medicaid funds to buy insurance on the state's federally run health insurance exchange for low-income Arkansans.
Termination letters also have gone to 7,929 children covered by the ARKids First program and 3,342 low-income parents or caretaker relatives, Luck said.
Arkansas Blue Cross and Blue Shield and St. Louis-based Centene Corp. have said they will continue prescription drug coverage for 30 days for private-option enrollees whose failure to respond to Human Services Department notices in time resulted in their coverage ending July 31, as well as those whose coverage ends Aug. 31 for the same reason.
During the 30-day extended coverage period, the companies also will treat medical claims as "pending."
If an enrollee's Medicaid eligibility is not reinstated within the 30-day window, the companies will pay for the drugs, but not for the medical services.
The companies won't receive monthly premiums for the extension for enrollees whose coverage is not reinstated.
The legislative task force is exploring changes to the state's Medicaid program, including a program that will replace the private option after the federal waiver authorizing it expires in 2017.
On Thursday, the panel heard presentations from nine companies that administer Medicaid managed-care programs in other states.
The companies each responded to a request for information on how such companies can improve how Arkansas provides care to the mentally ill and disabled, including nursing-home residents and people with developmental disabilities.
Sen. Jim Hendren, R-Sulphur Springs and the chairman of the task force, said the panel will consider whether managed-care companies should be hired to administer benefits for the disabled as well as other populations, such as the more than 200,000 people now enrolled in the private option.
The presentations from the companies "convinced me that it's worth consideration," Hendren said.
"I was not presented anything that would make me say, 'We don't need to explore this,'" he said.
A Section on 08/21/2015