NATIONAL NEWS

Children getting wrongly dropped from Medicaid because of automation `glitch’

Aug 30, 2023, 1:24 PM | Updated: 2:28 pm

JEFFERSON CITY, Mo. (AP) — Children in many states are being wrongly cut off from Medicaid because of a “glitch” in the automated systems being used in a massive eligibility review for the government-run health care program, a top Medicaid official said Wednesday.

The federal Centers for Medicare and Medicaid Services is asking all states to review their computer-automated processes to make sure that children are evaluated separately from their parents — and aren’t losing coverage merely because of their parents’ ineligibility or inaction.

Though federal officials remained vague about the scope of the problem, it likely involves at least half the states and potentially affects millions of children, said Joan Alker, executive director of Georgetown University Center for Children and Families.

“I think it’s a very significant problem,” said Alker, whose center is tracking the Medicaid renewal process in each state.

In most states, children can qualify for Medicaid at household incomes that are several times higher than allowed for adults.

Yet in many states, “eligible kids are not being successfully renewed, and that is a violation of federal requirements,” said Daniel Tsai, director of the CMS Center for Medicaid and Children’s Health Insurance Program Services.

All states are in the midst of an enormous eligibility review for Medicaid. A pandemic-era prohibition on removing people from Medicaid ended in the spring, triggering the resumption of annual eligibility determinations. While the freeze was in effect, Medicaid enrollment swelled by nearly one-third, from 71 million people in February 2020 to 94 million in April 2023.

About 5 million people already have lost coverage as part of the eligibility reviews, according to an Associated Press tally from state reports.

States are encouraged to automatically renew people for Medicaid by using computer programs to review income and household information submitted for other social services, such as food aid or unemployment benefits. When that doesn’t work, states are to send notices to homes asking people to verify their eligibility information. When people fail to respond, they are dropped from Medicaid — a move described as a “procedural termination” by Medicaid officials.

Tsai said a “systems glitch” in some states is flagging entire households for further information — and dropping all family members when there’s no response — instead of reviewing each individual separately and automatically renewing children who remain eligible.

A top Medicaid official in Maryland confirmed it’s one of the states with that problem.

“Maryland has responded immediately and is working closely with CMS to resolve this issue in a way that helps keep eligible individuals, particularly children, covered on Medicaid,” said Ryan Moran, the state’s Medicaid director and deputy secretary of health care financing.

He said Maryland is pausing all procedural terminations in August, retroactively reinstating coverage for children who weren’t renewed in the automated process and working to fix its system as quickly as possible.

Moran said the state has identified 3,153 children who were potentially affected — a little less than 5% of the state’s total procedural terminations to date. Some of those children still could eventually be determined to be ineligible.

CMS sent letters Wednesday to states giving them until Sept. 13 to report whether their automated renewal systems have similar problems. Those that do are instructed to pause procedural terminations for affected individuals, reinstate coverage for those already dropped and devise a way to prevent further wrongful cutoffs until their automated systems can be fixed.

Some states already have taken steps to prevent such situations. Missouri’s computer system cannot automatically renew coverage when a child is eligible but a parent’s eligibility is in question. So staff are handling those cases manually, often causing the process to extend into another month, said Caitlin Whaley, a spokesperson for the Missouri Department of Social Services.

___

Associated Press writer Brian Witte contributed from Annapolis, Maryland.

National News

Associated Press

Border arrests plunge 29% in June to the lowest of Biden’s presidency as asylum halt takes hold

SAN DIEGO (AP) — Arrests for illegally crossing the border from Mexico plunged 29% in June, the lowest month of Joe Biden’s presidency, according to figures released Monday that provide another window on the impact of a new rule to temporarily suspend asylum. Arrests totaled 83,536 in June, down from 117,901 in May to mark […]

1 hour ago

Photo: A delegate wears a hat with pins during the Republican National Convention Monday, July 15, ...

Christine Fernando, Steve People and Jill Colvin, The Associated Press

Rep. Walsh speaks for Washington as cheering GOP delegates nominate Trump for president

Cheering GOP delegates formally nominated Donald Trump for president at Monday's Republican National Convention kickoff.

1 hour ago

FILE - People walk past May Hall, the main administrative building at Dickinson State University in...

Associated Press

President of Dickinson State University in North Dakota resigns after nursing faculty quit

DICKINSON, N.D. (AP) — The president of Dickinson State University in North Dakota announced his resignation on Monday, days after the school’s nursing faculty quit. In a video, Steve Easton announced his departure and acknowledged “turmoil between some in the faculty and the administration.” Seven faculty members resigned Wednesday, KFYR-TV reported. Former Assistant Professor of […]

2 hours ago

Associated Press

FACT FOCUS: A look at false claims around the assassination attempt on former President Trump

The assassination attempt on former President Donald Trump, who is running for reelection, is fueling a range of false claims and conspiracy theories as authorities seek information about the 20-year-old shooter’s background and motive, how he obtained the AR-style rifle he fired at Trump and security at the venue that failed to stop the shooting. […]

2 hours ago

FILE - Christina Osborn and her children, Alexander Osborn and Bella Araiza, visit a makeshift memo...

Associated Press

Judge clears way for demolition of Texas church where 26 people were killed in 2017 shooting

FLORESVILLE, Texas (AP) — A judge on Monday cleared the way for the demolition of the small Texas church in Sutherland Springs where a gunman killed more than two dozen worshippers in 2017 in what remains the deadliest church shooting in U.S. history. Following the shooting at First Baptist Church of Sutherland Springs, the church […]

2 hours ago

RNC Chair Michael Whatley speaks during the Republican National Convention Monday, July 15, 2024, i...

Associated Press

Outside RNC, conservative group defends its Project 2025 guidebook as Democrats ramp up attacks

MILWAUKEE (AP) — At the edge of the cordoned-off perimeter around the Republican National Convention on Monday, hundreds of conservatives filed into the ornate home of the Milwaukee Symphony to hear a parade of luminaries talk policy and Project 2025. Project 2025 is the term for the Heritage Foundation’s nearly 1,000-page handbook for the next […]

2 hours ago

Children getting wrongly dropped from Medicaid because of automation `glitch’