A legal-aid group filed a lawsuit Wednesday saying the Arkansas Department of Human Services has failed to comply with requests for records on possible delays in approval of Medicaid applications.
The lawsuit comes as the state Department of Human Services works to fix problems with a new computerized registration and eligibility system.
Jonesboro-based Legal Aid of Arkansas contends that the department did not fully comply with requests the organization made under the state Freedom of Information Act on May 27 and July 20. The nonprofit provides free legal help to Arkansans in 31 Arkansas counties.
The organization said in the suit that it made the requests after receiving "numerous" credible reports that applicants for coverage under the private option, as well as for Medicaid coverage for pregnant women, were not receiving notice of their eligibility within 45 days as required by federal law.
Others were approved but not given active Medicaid numbers that doctors could use to bill for medical care, the suit says.
"These delays mean they're missing cancer treatments, they're not getting prenatal care, they're not getting medicines to help with chronic health conditions like diabetes, blood pressure, things like that," Legal Aid of Arkansas Director Lee Richardson said Wednesday.
"We're not blaming anybody. We're just trying to determine what the holdup is and hopefully get workable and prompt solutions in place."
Human Services Department spokesman Amy Webb said in an email that delays in processing applications are "not a widespread issue."
In some cases, matters such as missing data "have caused applications to get stuck mid-process" she said.
"The system isn't able to process them, so they will have to be done manually. Those are very time-consuming to work."
She said that the Human Services Department has responded to Legal Aid of Arkansas' Freedom of Information Act requests.
"We've also requested Legal Aid send us a list of individuals who they think are eligible but still have pending applications so that we could prioritize them and ensure people who need coverage get it," Webb said.
"To date, we have not received any such list."
Legal Aid of Arkansas attorney Kevin De Liban, who filed the Freedom of Information Act requests, said his group heard from other organizations that found submitting such lists were not successful.
When an applicant contacts Legal Aid of Arkansas about an application that has been pending for more than 45 days, the group requests an administrative hearing on the matter, he said. That has been effective in prodding the department to make a determination about the applicant's eligibility, he said.
"The issue is about all the people who don't have the good fortune to come to Legal Aid of Arkansas," he said.
In response to De Liban's first request for information about application-processing times, a Human Services Department official responded in a June 2 email that the department had no records responsive to the request.
The department "is not required to compile information, or create a record in response to a request" under the open-records law, the official added.
"After further discussion between the parties," the department provided some information but excluded any information about the private option, according to the lawsuit.
In response to the July 20 request, the Human Services Department provided 798 emails, including some that indicate that the department has additional records that it has not provided, the lawsuit says.
A report that Legal Aid of Arkansas did obtain through its second open-records request indicates that 22,472 applications for coverage were pending as of Nov. 29, including some that had been submitted almost a year earlier, De Liban said.
About 69 percent of the applications that had been filed were processed within 45 days, he said.
The Human Services Department didn't respond Wednesday to a request from the Arkansas Democrat-Gazette for records related to the department's performance in processing applications within 45 days.
Last month, Mark White, the department's deputy director, told the state Legislative Joint Auditing Committee's Medicaid Subcommittee that programmers are working to fix "serious defects" with the Medicaid enrollment system that have caused "unacceptable wait times" for applications to be approved.
Those defects should be fixed within six to eight months, he said.
The new system, under construction since April 2013, is being installed because the department's older system can't determine eligibility under rules that went into effect Jan. 1, 2014, under the 2010 federal Patient Protection and Affordable Care Act, officials have said.
The ongoing work on the system has been blamed for a delay in checking the incomes of private-option enrollees and other Medicaid recipients who have been signed up for at least a year.
As of last week, the coverage for more than 58,000 recipients had ended or was set to end because of the income checks, which began in mid-May.
Under the private option, the state uses federal funds to buy private insurance for adults who became eligible for coverage under the expansion of the state's Medicaid program. More than 259,000 people had been approved for coverage under the expanded Medicaid program as of June 30.
Legal Aid of Arkansas is one of two groups in the state that receive federal funding to provide legal services to the poor. The Center for Arkansas Legal Services serves the state's other 44 counties, including Pulaski County.
Legal Aid of Arkansas has also hired outreach workers to help people sign up for coverage made available under the Affordable Care Act.
De Liban, who works in Legal Aid of Arkansas' West Memphis office, said the organization spread the word in May that it would provide free legal help to people experiencing delays in being approved for medical coverage. More than 100 people contacted the group within two weeks of that effort, he said.
About half of those who responded have since been approved for coverage, he said.
Those the organization has helped include Merrie Bennett, 52, of Clarendon. She said she became uninsured after she suffered a seizure and was no longer able to work at her job at a rice mill in Stuttgart.
She applied for Medicaid coverage earlier this year and was approved about three months later, she said.
While she waited for word on her application, she was able to see a doctor at a community health center, she said. But she needed the Medicaid coverage to be able to see a specialist for her seizures and go to follow-up doctor's visits for her breast cancer, for which she was treated before losing her job, she said.
The approval came in time for her to make those visits, she said.
"I guess the Lord provided for me," Bennett said.
Metro on 08/27/2015