Eligibility check: The feds are right to ask about assistance cutoffs

July 17, 2012 12:04 am

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In 2011, Pennsylvania's Department of Public Welfare cut off more than 100,000 people who had been receiving Medical Assistance, and tens of thousands more this year have lost that insurance, which covers those who are disabled, poor or gravely ill -- many of them children.

Advocates for the clients and even some Welfare Department employees have questioned the process that was used to scale back coverage, and now the Obama administration is asking, too.

In a letter to state officials, the Department of Health and Human Services asked for evidence that the benefits were properly withdrawn. The letter, dated June 14, questioned whether correct procedures were followed for reviewing eligibility and noted that the purge occurred at the same time that DPW was struggling with a backlog of cases.

In the letter, Anne Marie Costello, director of the eligibility division for HHS's Centers for Medicare and Medicaid Services, said many of the cases were closed because applicants failed to provide the proper forms "at a time when DPW has reported that it was unable to process within appropriate timeframes all the information beneficiaries had submitted."

For example, an August 2011 audit of one DPW office in Philadelphia said 474 boxes of documents sat waiting to be filed. A caseworker in Pittsburgh's Strip District welfare office reported last year that, as the department stepped up reviews, there were problems with new computer equipment.

It seems plausible, if not likely, that beneficiaries caught in that Catch-22 might have done everything necessary to retain coverage but lost it anyway.

The sooner the Welfare Department can complete its reviews and notify federal officials, the better for recipients who deserve to have benefits reinstated. That's particularly true because the state this month began changing the documentation that health-care workers must provide to applicants for new benefits or renewals.

It is important especially in tight financial times that the state provides assistance only for the individuals who qualify for help, but it is equally important that those who are most in need don't lose benefits unfairly and through no fault of their own.


First Published July 17, 2012 12:00 am

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