Arkansas has been granted a three-month extension, until Dec. 31, to finish checking the incomes of 600,000 Medicaid recipients who have been enrolled for at least a year, the director of the state Department of Human Services said Monday.
Human Services Director John Selig told the Legislature's public health committees that the state also is exploring changes, including using additional data sources, to speed up the processing of applications and annual income verifications.
"It is very important that we get accurate information and make sure that people who are on the program are actually eligible for it, but that is balanced in part by just how many state employees it takes to do that," Selig said.
The department plans to have any such changes in place before resuming the annual eligibility checks, which have been on hold since Aug. 21, he said.
Originally expected to begin last fall, the state's income reviews were delayed by seven months because of difficulties the Human Services Department has encountered in building the enrollment and eligibility verification system.
The new system is needed to conduct the income checks according to rules that went into effect Jan. 1, 2014, under the 2010 federal Patient Protection and Affordable Care Act, department officials have said.
Selig said the system has only been able to complete 20 percent of applications and renewals without any manual work by department staff. It had been expected to do that 80 percent of the time.
The annual income reviews were stopped after officials with the federal Centers for Medicare and Medicaid Services said they would be issuing "changed guidance" about the department's practice of giving Medicaid recipients 10 days to respond to requests for income-related records.
The Human Services Department is revising the income-request notices to give recipients 30 days to provide the records.
So far, the department has renewed coverage for 74,530 Medicaid recipients and issued termination notices to 60,399, department spokesman Amy Webb said.
Of those who have received termination notices, 3,799 were found to be ineligible and 56,600 failed to provide income-related records to the department.
Such records are requested when state wage records on a recipient are not available or indicate that a recipient's eligibility status has changed, Human Services Department officials have said.
Among the changes the department is considering is not making the records requests of recipients who reported having no income in their initial applications and are found during the annual review to have no income listed in state wage records.
In such cases, the department currently requires recipients to submit statements declaring that they have no income.
But Selig noted that other recipients could have income that is not recorded in state wage records, and the department does not require them to submit written statements.
Ultimately, the recipients have a responsibility to report any income changes that affect their eligibility, he said.
Selig said the department also has made progress in clearing out a backlog of applications for coverage.
As of Aug. 2, as many as 31,400 Arkansans had been waiting longer than 45 days -- the maximum amount of time allowed under federal rules -- for word about whether their applications had been approved.
Such delays have been widespread among children born to mothers who are on Medicaid.
Under federal rules, the children are automatically eligible for Medicaid, but the enrollment system cannot automatically extend coverage to them.
Selig told legislators that a backlog of "thousands" of applications for newborns' Medicaid coverage has been reduced by about 75 percent.
Within about two weeks, the department expects the enrollment system to be able to automatically extend coverage to the newborns, he said.
David Wroten, executive vice president of the Arkansas Medical Society, has said that many doctors are providing care for the newborns without being reimbursed while they wait for the applications to be approved.
"I know that there are still problems and that they're still behind" on processing the applications, Wroten said after the committee meeting Monday.
"We are still encouraging our physicians to hang in there, but they are being very nervous about it because we've never seen this before."
Metro on 10/06/2015