Federal judge calls for D.C. Medicaid fixA federal judge next month will hear proposals on how the District of Columbia should fix the management of its Medicaid program so that administrative problems do not lead the district to i mproperly deny benefits to enrollees.
Ruling in a lawsuit filed against the District of Columbia government, U.S. District Court Judge Gladys Kessler said the Washington Medicaid program was so badly managed that it was violating th e rights of the district's 115,000 Medicaid beneficiaries, who represent about one-quarter of the district's population.
Kessler ruled that the district failed to process applications to enroll in nondisability-related Medicaid with in the required 45 days, to adequately notify beneficiaries that their eligibility was about to expire, and to notify beneficiaries about preventive services or to provide such services.
Hospitals and other providers said they frequ ently received inaccurate information from the district's electronic system for verifying whether patients carrying Medicaid cards were in fact eligible. When the verification system falsely told providers a beneficiary was eligible, the providers often were left with an unpaid bill.
Kessler ordered lawyers for the plaintiffs and the district to present her with proposals to fix the program at least five days before the next hearing on Nov. 21.