UNITED STATES NEWS

Children getting wrongly dropped from Medicaid because of automation `glitch’

Aug 30, 2023, 1:24 PM | Updated: 2:28 pm

JEFFERSON CITY, Mo. (AP) — Children in many states are being wrongly cut off from Medicaid because of a “glitch” in the automated systems being used in a massive eligibility review for the government-run health care program, a top Medicaid official said Wednesday.

The federal Centers for Medicare and Medicaid Services is asking all states to review their computer-automated processes to make sure that children are evaluated separately from their parents — and aren’t losing coverage merely because of their parents’ ineligibility or inaction.

Though federal officials remained vague about the scope of the problem, it likely involves at least half the states and potentially affects millions of children, said Joan Alker, executive director of Georgetown University Center for Children and Families.

“I think it’s a very significant problem,” said Alker, whose center is tracking the Medicaid renewal process in each state.

In most states, children can qualify for Medicaid at household incomes that are several times higher than allowed for adults.

Yet in many states, “eligible kids are not being successfully renewed, and that is a violation of federal requirements,” said Daniel Tsai, director of the CMS Center for Medicaid and Children’s Health Insurance Program Services.

All states are in the midst of an enormous eligibility review for Medicaid. A pandemic-era prohibition on removing people from Medicaid ended in the spring, triggering the resumption of annual eligibility determinations. While the freeze was in effect, Medicaid enrollment swelled by nearly one-third, from 71 million people in February 2020 to 94 million in April 2023.

About 5 million people already have lost coverage as part of the eligibility reviews, according to an Associated Press tally from state reports.

States are encouraged to automatically renew people for Medicaid by using computer programs to review income and household information submitted for other social services, such as food aid or unemployment benefits. When that doesn’t work, states are to send notices to homes asking people to verify their eligibility information. When people fail to respond, they are dropped from Medicaid — a move described as a “procedural termination” by Medicaid officials.

Tsai said a “systems glitch” in some states is flagging entire households for further information — and dropping all family members when there’s no response — instead of reviewing each individual separately and automatically renewing children who remain eligible.

A top Medicaid official in Maryland confirmed it’s one of the states with that problem.

“Maryland has responded immediately and is working closely with CMS to resolve this issue in a way that helps keep eligible individuals, particularly children, covered on Medicaid,” said Ryan Moran, the state’s Medicaid director and deputy secretary of health care financing.

He said Maryland is pausing all procedural terminations in August, retroactively reinstating coverage for children who weren’t renewed in the automated process and working to fix its system as quickly as possible.

Moran said the state has identified 3,153 children who were potentially affected — a little less than 5% of the state’s total procedural terminations to date. Some of those children still could eventually be determined to be ineligible.

CMS sent letters Wednesday to states giving them until Sept. 13 to report whether their automated renewal systems have similar problems. Those that do are instructed to pause procedural terminations for affected individuals, reinstate coverage for those already dropped and devise a way to prevent further wrongful cutoffs until their automated systems can be fixed.

Some states already have taken steps to prevent such situations. Missouri’s computer system cannot automatically renew coverage when a child is eligible but a parent’s eligibility is in question. So staff are handling those cases manually, often causing the process to extend into another month, said Caitlin Whaley, a spokesperson for the Missouri Department of Social Services.

___

Associated Press writer Brian Witte contributed from Annapolis, Maryland.

United States News

Associated Press

‘Catch and kill’ will be described to jurors in Donald Trump’s hush money trial as testimony resumes

NEW YORK (AP) — A longtime tabloid publisher was expected Tuesday to tell jurors about his efforts to help Donald Trump stifle unflattering stories during the 2016 campaign as testimony resumes in the historic hush money trial of the former president. David Pecker, the former National Enquirer publisher who prosecutors say worked with Trump and […]

8 hours ago

Associated Press

America’s child care crisis is holding back moms without college degrees

AUBURN, Wash. (AP) — After a series of lower-paying jobs, Nicole Slemp finally landed one she loved. She was a secretary for Washington’s child services department, a job that came with her own cubicle, and she had a knack for working with families in difficult situations. Slemp expected to return to work after having her […]

8 hours ago

Several hundred students and pro-Palestinian supporters rally at the intersection of Grove and Coll...

Associated Press

Pro-Palestinian protests sweep US college campuses following mass arrests at Columbia

NEW YORK (AP) — Columbia canceled in-person classes, dozens of protesters were arrested at New York University and Yale, and the gates to Harvard Yard were closed to the public Monday as some of the most prestigious U.S. universities sought to defuse campus tensions over Israel’s war with Hamas. More than 100 pro-Palestinian demonstrators who […]

10 hours ago

Ban on sleeping outdoors under consideration in Supreme Court...

Associated Press

With homelessness on the rise, the Supreme Court weighs bans on sleeping outdoors

The Supreme Court is wrestling with major questions about the growing issue of homelessness as it considers a ban on sleeping outdoors.

11 hours ago

Arizona judge declares mistrial in case of rancher who shot migrant...

Associated Press

Arizona judge declares mistrial in the case of a rancher accused of fatally shooting a migrant

An Arizona judge declared a mistrial in the case of rancher accused of killing a Mexican man on his property near the U.S.-Mexico border.

12 hours ago

Associated Press

Trial opens for former Virginia hospital medical director accused of sexual abuse of ex-patients

NEW KENT, Va. (AP) — The former longtime medical director of a Virginia hospital that serves vulnerable children used physical examinations as a “ruse” to sexually abuse two teenage patients, a prosecutor said Monday, while the physician’s attorney “adamantly” denied any inappropriate conduct. The trial of Daniel N. Davidow of Richmond, who for decades served […]

12 hours ago

Sponsored Articles

...

DESERT INSTITUTE FOR SPINE CARE

Desert Institute for Spine Care is the place for weekend warriors to fix their back pain

Spring has sprung and nothing is better than March in Arizona. The temperatures are perfect and with the beautiful weather, Arizona has become a hotbed for hikers, runners, golfers, pickleball players and all types of weekend warriors.

...

COLLINS COMFORT MASTERS

Here are 5 things Arizona residents need to know about their HVAC system

It's warming back up in the Valley, which means it's time to think about your air conditioning system's preparedness for summer.

(KTAR News Graphic)...

Boys & Girls Clubs

KTAR launches online holiday auction benefitting Boys & Girls Clubs of the Valley

KTAR is teaming up with The Boys & Girls Clubs of the Valley for a holiday auction benefitting thousands of Valley kids.

Children getting wrongly dropped from Medicaid because of automation `glitch’