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Federal government questions Pennsylvania Medicaid rolls
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HARRISBURG -- The federal government is asking why Pennsylvania's Medicaid rolls dropped over the past year, and is suggesting that some people might have been improperly kicked off because caseworkers had not sorted through a serious backlog of information submitted by people seeking to keep the medical benefit.
The query comes after alarmed advocates for children and the poor say they have received hundreds of reports of people wrongfully losing benefits, while department figures show that tens of thousands of children have fallen off Medicaid rolls.
The rolls for benefits, including Medicaid and food stamps, have grown over the years, while caseworkers say their numbers have steadily dropped as governors sought to save money on employee costs.
A spokesman for the Centers for Medicare and Medicaid Services said it had not received a response to its June 14 letter that requests the results of the Pennsylvania Department of Public Welfare's review of 12,000 cases.
In the letter, a Centers for Medicare and Medicaid Services official said a large number of cases were closed for "failure to provide information" or "failure to return renewal form" at a time when department caseworkers were apparently unable to appropriately sort through the information that people had submitted to verify their eligibility.
"We consider DPW's re-review of closed cases to be an important step toward understanding the drop in Medicaid enrollment overall," CMS' director of Medicaid eligibility, Anne Marie Costello, wrote. "Reinstating improperly closed cases is also important, as is rectifying improper procedures, if warranted, to avert inappropriate terminations in the future."
The letter cited an April 18 meeting at which Department of Public Welfare officials said they would reinstate benefits for anyone in the 12,000 cases who was improperly kicked off Medicaid, a 47-year-old federal-state program that provides medical care for the poor and disabled.
State officials told CMS that they would use the review to identify patterns that may have led to people improperly losing the benefit. The first phase of the review would cover 3,000 pregnant women and babies, the letter cited department officials as saying.
A DPW spokeswoman said Wednesday that the reviews were not finished. The spokeswoman, Carey Miller, said the agency is not sure how many people were improperly kicked off Medicaid, but she did not dispute that some had been.
"We're working with CMS to make sure that everything is followed per protocol," Ms. Miller said. "Human error is something that does occur in instances where you have people processing paperwork, that sort of thing does happen. We do our best to correct it as expeditiously as we can."
Ms. Miller said the agency did not know how such corrections compare to previous years, but she said agency officials are working to improve the way the department operates, and that they believe they are in compliance with federal rules that govern how Medicaid applications are to be reviewed.
According to department numbers, the number of Pennsylvanians covered by Medicaid dropped by about 44,000 to 2.2 million in May from August, when the department aggressively stepped up eligibility reviews.
The part that has particularly alarmed advocates for children and the poor is that the number of children covered by Medicaid dropped by 86,000 during that period after rising steadily in the prior years.
First Published July 12, 2012 12:00 am
