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Missouri answers feds on Medicaid backlog [St. Louis Post-Dispatch :: ]
[July 14, 2014]

Missouri answers feds on Medicaid backlog [St. Louis Post-Dispatch :: ]


(St. Louis Post-Dispatch (MO) Via Acquire Media NewsEdge) July 15--Time is up for the state of Missouri and five other states to come up with a plan to address backlogs in Medicaid applications.

Officials at the Centers for Medicare and Medicaid Services on June 27 gave the six states until Monday to address deficiencies in how they process applications from HealthCare.gov, the online health insurance marketplace operated by the federal government.



Dr. Joe Parks, head of Missouri's Medicaid program, in a letter sent Monday to CMS, cited computer software problems that prevented the smooth exchange of data. He said Missouri has "reached out to other states to seek solutions" and is in the process of fixing the computer problems.

Testing of the state's system fixes will begin in August, Parks said in the letter.


When HealthCare.gov launched last October the idea was to have no "wrong door" policy, meaning those applying for coverage who were also deemed eligible for the state's Medicaid program would be routed directly into each state's computer systems.

That didn't happen seamlessly.

For Missouri and many other states, the computer systems could not transfer these accounts properly and it created a backlog of applications, said Matt Salo, executive director of the National Association of Medicaid Directors. But when the "pipes" were cleared the applications all got "dumped instantaneously on the states," Salo said.

"When all of those applications came through the pipes, and landed on Missouri's desk, it wasn't as if they could take those (applications) and just put them in the computer and run them through," Salo said. "In many cases the applications they received were incomplete." That meant staffers had to intervene and deal with each application individually to collect the appropriate or missing information, according to Rebecca Woelfel, spokeswoman for the Department of Social Services.

CMS, in its June 27 letter, said Missouri is performing up to par in all other areas except in its ability to deal with these account transfers.

Since Feb. 17, Missouri has received 51,600 account transfers from the HealthCare.gov and 39,000 of those applications have been processed. And just 3,100 individuals were deemed eligible for coverage, Woelfel said. The remaining 12,600 are being reviewed for eligibility determinations, she said.

In addition to Missouri, the other states that ran into trouble processing Medicaid applications are Alaska, California, Kansas, Michigan and Tennessee. Since the launch of HealthCare.gov last October, nearly 7 million individuals, including children, have been added to Medicaid coverage across the nation.

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