Thursday, June 16, 2016

CORRECTION: DHS now says thousands who should be covered by Medicaid victims of computer glitch

Posted By on Thu, Jun 16, 2016 at 10:25 AM

The Arkansas Department of Human Services says that reporting by KTHV, Channel 11 — which said 120,000 Arkansans weren't being covered by Medicaid because of computer problems — is in error, and that therefore our blog post is in error. (The original post is at the bottom.) DHS has asked KTHV to correct its reporting.

Spokesperson Amy Webb said the 120,000 people the report referred to was a misinterpretation of data presented to a legislative health care task force last week and then provided to a producer at KTHV. She said some of those 120,000 are still receiving Medicaid assistance, but she could not provide a figure of how many Medicaid-eligible patients are not being covered. But of those, no doubt many are not being covered because of the problem. How many thousands isn't clear. 

You can see a Power Point presentation of the data here.
The 121,972 cases referred to in the report include "current" cases — a total of 11,286 renewal, pending or "change of circumstance" applications that have been received but work has not begun on them (DHS has 45 days to process an application); 92,815 "overdue at caseworker level" cases, including 51,172 "change of circumstance" cases that are causing data errors; 9,583 "overdue at system level" cases, cases in which data from DHS is not properly crossing over  into the Medicaid data base used by providers; and 8,288 "overdue problem cases."  The "overdue problem cases" are being sent to a "specialized team" to try to determine why there are problems with data, Webb said. It would seem that you could add those to the "overdue at system level" cases to get the minimum number of Medicaid-eligible children and adults who, because of computer problems, can't get coverage.

The  recipients in the "overdue at caseworker level" include people who are still covered and people not receiving coverage, Webb said. It also includes 25,000 people who are not eligible, Webb said.

The DHS budget to fix these problems is $8.38 million, but only $2.09 million will come from the state because of a 75/25 federal-state match. Of that total, $7.5 million will go to hire 200 temporary caseworkers under a contract with Maximus, which does "surge eligibility work," Webb said; $2.6 million will got to E-Systems to make fixes to the computer system so it can handle the "big problem" cases; and $875,000 to the Arkansas Foundation for Medical Care's to allow it to expand the call center it operates for DHS and extend its hours from 7 a.m. to 7 p.m. The contracts will be taken up by the legislature in July, she said.

Below is our earlier post.

More than 120,000 Arkansans, many of them children who should be provided health insurance under the state's ARKids Medicaid program, are the victims of computer "glitches" at the state Department of Human Services and have been denied coverage.

KTHV Channel 11 reported the news last night, providing a number given them by Amy Webb, a spokesperson for DHS and recently elevated to chief communications and community engagement officer. 

The Times reported on the ARKids problem in May, but Webb at the time said DHS could not provide the number of persons affected. The Channel 11 report focused — as did the Times story — on ARKids patients, but did not say how many of the 120,000 problem applications were for children and how many for adults. The Times has a call into Webb to straighten the numbers out, if possible.

Channel 11 reported that information from many applications for coverage — all had to reapply this year because of new Medicaid rules — had been deleted by the computer glitch, causing them to lose coverage. Webb also told Channel 11 that some applicants are "caught in the backlog."
This means that some children are going without expensive medicine they need, and hospitals and other facilities are not being paid for services rendered. Channel 11 reports:
Webb said that DHS created a plan to clear the backlog of what it calls “cross-over” cases. The plan involves reassigning some staff members and hiring additional caseworkers. The plan would cost Arkansas slightly more than $2 million, and would potentially fix all the problems by the end of the year.
By the end of the year? That won't come soon enough for kids with broken arms, like the one mentioned in the KTHV report, or children receiving inpatient mental health services from providers like Our House, or children needing prescriptions filled.

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