Kinks in the system as Gov. Asa Hutchinson plows full speed ahead with troubled Medicaid verification system | Arkansas Blog

Thursday, August 20, 2015

Kinks in the system as Gov. Asa Hutchinson plows full speed ahead with troubled Medicaid verification system

Posted By on Thu, Aug 20, 2015 at 9:15 AM

click to enlarge KINKS IN THE SYSTEM: Is DHS prepared for the bureaucratic nightmare to come?
  • KINKS IN THE SYSTEM: Is DHS prepared for the bureaucratic nightmare to come?

***UPDATE: By the afternoon, DHS had fixed the dead link for Explorer, though it's still not working for Chrome or Firefox. DHS also now 
has another link on the home page — "Who to contact if you have Healthcare Coverage questions & FAQs about Renewal" — that works without kinks and eventually links to more detailed information. 

Gov. Asa Hutchinson had a What, me worry? press conference on Tuesday, insisting that the state was ready to fire up the engines on its troubled income-verification-and-renewal system for Medicaid beneficiaries.

After what we've seen the last month, I think it's fair to say that some kinks and problems are inevitable. Some folks trying to access the system pointed out a simple one to us, which we verified this morning: the DHS home page has a link in a corner that says "Current Clients Encouraged to Respond to Request for Info during Renewal Process." That takes people to an informational PDF — at the bottom, it stays, "If enrollees aren’t sure who to contact with questions, they can use this guide to determine the best contact." Unfortunately, if you click the link to that guide, you get the "File Not Found" message above. We tried it in Chrome, Explorer, and Firefox and the link appears to be dead. This too bad because the information in the PDF doesn't explain what documentation self-employed people or unemployed people need (and it mentions offering one pay stub when DHS actually needs more than one pay stub from the previous month — for more details on what's needed, see here). 

Obviously, mistakes happen, and this is a small and easily fixable one. But these are the kinds of kinks that take time to sort out when you have an overwhelmed agency facing a bureaucratic nightmare likely to get worse before it gets better. 
Meanwhile, we've heard from multiple beneficiaries and brokers who say that they turned in their paperwork on time in the first place but had coverage terminated because DHS failed to process it on time. They have been contacting DHS yesterday and today only to find that they still have not been reinstated.These are eligible beneficiaries who had their plans cancelled through no fault of their own. Their coverage remains terminated, threatening their access to needed care. DHS confirmed that the reinstatement process for beneficiaries in this situation is not yet complete. This qualifies as "no more backlog" to the governor, apparently. 

Finally, unsurprisingly, we're still getting reports of county offices overwhelmed with the volume of calls and questions. 

Again, this process is going to take time and there are going to be hiccups along the way. The point here is not to blame DHS for the inevitable bumps in the road. The problem is that the governor knows that many or most of those who have lost coverage are in fact eligible. And he knows that many of them face alarming problems with access to care right now — with more coming on September 1. The deal struck with two insurance companies to provide pharmacy care to some beneficiaries definitely helps, but it doesn't help all beneficiaries or all situations — and thousands of the most vulnerable beneficiaries (kids, the medically frail, and extremely poor parents of dependent children) get no relief from that deal at all. They still won't be able to get needed meds this month, with potentially dire consequences. 

Under the circumstances, it is astonishing that Hutchinson refused to reconsider the 10-day-response deadline for beneficiaries, against the advice of the state's own consultant. Hutchinson said that he wanted to stick with the "status quo," a disastrous process that led to tens of thousands of eligible beneficiaries losing coverage and a bureaucratic fiasco that has overwhelmed DHS. 

Hutchinson insisted on powering ahead despite the fact that DHS still has a backlog on reinstating eligible beneficiaries who had their coverage terminated, sent in the necessary paperwork, and are now waiting on the state. He insisted on powering ahead despite the fact that DHS is likely weeks away from actually completing the income verifications that are the whole point of this exercise. 

DHS is facing a massively steep climb. They are facing a volume of questions and responses likely to grow even more. Keep in mind that tens of thousands more reinstatements will need to be processed soon, since many or most of those kicked off are actually eligible. The problems that led to the agency falling behind may well recur. The insurance companies are helping to pick up the slack, but there is still almost nothing in place in terms of an outreach program by the state to communicate with confused, hard-to-reach beneficiaries (a process made nearly impossible with the 10-day deadline). And the inevitable kinks? They'll delay eligible beneficiaries being able to access care they need. The risks here could have tragic consequences. 

And here's the biggest issue of all: the governor is prioritizing initiating new income verifications over reinstating eligible beneficiaries who have lost coverage. He is sticking with a policy doomed to another massive wave of cancellations of people eligible for the program according to the state's own data. He is pushing forward with a system and policy guaranteed to flood DHS with volume, before the kinks have fully been worked out, even as they remain behind on reinstatements. In the wake of a disaster partly the result of his own policies, he is choosing to be overzealous rather than cautious, with the lives of the state's most vulnerable citizens at stake. 

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