Eliminated state's Medicaid sign-up backlog, DHS chief reports

With the help of about 250 temporary caseworkers, the Arkansas Department of Human Services "essentially" met its goal to eliminate a backlog of Medicaid applications and other overdue paperwork by the end of 2016, the department's director said in a letter Wednesday.

As of Dec. 30, the department had 692 Medicaid cases with overdue paperwork, but none of those involved people who were waiting for their applications to be approved, Director Cindy Gillespie said in the letter to Gov. Asa Hutchinson.

"Based on a review of the remaining cases, all individuals have coverage and the only work that remains is simply clean-up of case files," Gillespie said in the letter.

By comparison, department officials said in June that more than 100,000 pieces of paperwork were overdue, including applications from about 34,000 Arkansans that had been pending for more than 45 days.

Gillespie said in the letter that the reduction is "remarkable when you consider that when we started this effort in August, there were individuals waiting on an eligibility determination who had applied in 2014."

Through a spokesman, Hutchinson expressed appreciation for workers' "extraordinary efforts and the extra hours they put in."

"This effort took extra time by workers, weekly planning sessions and strong leadership, and I commend them all for their work," Hutchinson said.

The Arkansas Democrat-Gazette reported in September 2015 that as many as 31,400 Arkansans had been waiting for longer than 45 days -- the maximum amount of time allowed under federal rules -- for word on whether their Medicaid applications had been approved.

In one case, a mother who was already on Medicaid said her daughter had missed recommended checkups and immunizations during the six months after the girl's birth that it took for a coverage application to be approved.

In other cases, clinics waited to be reimbursed for tens of thousands of dollars' worth of care they had provided to Arkansans whose Medicaid applications were pending.

In addition to applications, the overdue paperwork as of June included more than 51,000 requests for changes to Medicaid recipients' coverage that had been pending for more than 20 days.

Such changes could result from an increase in a recipient's income or a request for the coverage to be canceled because the recipient had enrolled in employer-sponsored coverage, Gillespie has said.

The backlog stemmed from trouble the department encountered installing a new enrollment and eligibility system, which began processing applications in the fall of 2013.

The system was needed to determine eligibility for coverage under new rules, created as a result of the 2010 Patient Protection and Affordable Care Act that took effect Jan. 1, 2014.

Although the system's performance has improved, its initial poor functioning caused applications and other paperwork to pile up, Gillespie has said.

Gillespie, who took over as department director in March, allocated about $8.5 million in state and federal Medicaid funds to clear out the backlog. That included $7.5 million to hire a "surge" of about 250 temporary caseworkers who began processing paperwork in September, as well as money for department contractors to hire more computer programmers and call-center workers.

The temporary contracts ended at the end of last month, Human Services Department spokesman Amy Webb said Wednesday.

The Medicaid program covers more than 1 million people in the state, including more than 324,000 low-income adults who were enrolled as of Sept. 30 as part of an expansion of the program authorized under the Patient Protection and Affordable Care Act.

Of the 692 cases that remained overdue as of Dec. 30, some involve requests for information that have been sent to Medicaid recipients and can't be closed until the deadline expires for the recipients to provide the information, Webb said.

Other cases involve errors in electronic files that have been flagged for correction but don't affect a recipient's eligibility, she said.

David Wroten, executive vice president of the Arkansas Medical Society, said Wednesday that it's been more than a month since he's heard a complaint from a physician about a delay in a patient's Medicaid application being processed.

But he said the earlier delays continue to pose difficulties for doctors who are participating in a Medicaid program that provides them with extra payments for coordinating patients' medical care and holding down their overall health care costs.

For instance, he said, patients whose Medicaid applications were pending may not have been counted by department officials in determining doctors' eligibility for bonuses under the program.

"It's probably going to take us several months to a year to just work out all the kinks and all the problems that were created because of the backlog," he said.

A Section on 01/12/2017