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California plans to cut Medicaid application backlog by September, CMS told


By Virgil Dickson
Posted: July 17, 2014 - 8:00 pm ET
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California hopes to decrease its Medicaid application backlog to 350,000 potential enrollees by September from the 600,000 applications it had on hand at the end of June, the state said in a letter (PDF) sent to the CMS earlier this week. California was among six states the CMS flagged for ongoing technical and administrative woes that have delayed Medicaid access for their residents.

The CMS on June 27 asked the states how they planned to clear their application backlogs. It gave the states— Alaska, California, Kansas, Michigan, Missouri and Tennessee—until July 14 to respond. All met that deadline Monday.

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While some states, like California, outlined plans to clear backlogged Medicaid applications received from HealthCare.gov, others used their letters as an opportunity to criticize the CMS, blaming it for their processing woes.

When California cuts its backlog to 350,000 applications, it expects those remaining will primarily be from individuals who recently submitted applications, along with a smaller number of cases that require intensive manual work because of data errors or missing applicant information.

Officials in Alaska, Kansas, Michigan and Missouri say that, in their cases, CMS' primary concern has been more about those states' ability to share information with CMS systems, as opposed to actual backlogs.

Alaska estimates (PDF) that it has 4,000 applications waiting to be processed from the federal exchange, though it's been able to determine eligibility for many applicants in other ways. It believes its state portal for receiving information from the federal marketplace will be operational by the end of the month.

Missouri said its staff had completed 39,000 of the 51,600 applications that have come through the federally run marketplace since February. It criticized the CMS for not rigorously screening applicants sent to the state. Eligibility for the Missouri program is limited, since it is a non-expansion state. To date, only 8% of the applicants sent to Missouri from HealthCare.gov have been found to be eligible.

“The current transfer standards would appear to give too many applicants a false expectation of coverage under Missouri's Medicaid Program,” Dr. Joseph Parks, Missouri's Medicaid director, wrote in his response letter (PDF). The state hopes to begin testing its system to seamlessly send and receive data from the federal marketplace in August.

Kansas informed the agency that it has completed design of a contingency process (PDF) for receiving applications from the federally facilitated insurance marketplace that it hopes to implement between July 25 and July 28.

Michigan is currently prioritizing files waiting to be processed from HealthCare.gov. Once that task is finished, it hopes to start evaluating applicants from the federal insurance site by August 11, according to its response (PDF).

Tennessee blamed any perceived slowness in processing its applications on the CMS, noting that more than 126,300 residents enrolled in TennCare, the state's Medicaid program, between January and May. “While there are still improvements to be made, we are currently enrolling individuals at the highest rate in nearly 20 years,” the letter reads, adding that, “A small percentage of applicants have had difficulty completing the enrollment process, but almost all of those problems have been the result of flaws in the federal government's HealthCare.gov website, the federally facilitated marketplace.”

But Tennessee also said in its letter (PDF) that it had made a concession to enable hospitals to temporarily enroll pregnant women in Medicaid, something the CMS had been imploring it to do.

Follow Virgil Dickson on Twitter: @MHVDickson


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