Feds plan review of FSSA over Medicaid backlog

Stethoscope health medical clinic
(WISH Photo, file)

INDIANAPOLIS (AP) — Federal officials are viewing Indiana’s procedures for enrolling residents in Medicaid after finding the state had 80,000 low-income residents awaiting approval in May.

Cindy Mann, director of the Centers for Medicare and Medicaid Services, notified Indiana Medicaid Director Joe Moser on July 9 that the federal government would begin reviewing the state’s procedures for enrolling residents immediately.

“The primary purpose of the review will be to gather additional information to determine the reasons for the backlog of applications, at a level of detail that would allow CMS to discern what numbers of people are being impacted, for what length of time, and by what operational or technical challenges or gaps,” Mann wrote.

CMS spokeswoman Elizabeth Schinderle said in a statement Thursday that Indiana is one of a handful of states being reviewed by the federal government. The backlog and federal review were first reported by the Indianapolis Business Journal Thursday. State officials told the newspaper that the backlog has been cut in half since it was first discovered in May.

FSSA spokesman Jim Gavin said the state first discovered problems with processing Medicaid applicants when it was preparing for the rollout of the federal health exchange last fall and alerted CMS at the time.

“The state foresaw these issues and in September of 2013, prior to the beginning of the federal open enrollment period, sent a letter to CMS outlining concerns noting ‘several outstanding issues that could significantly impact our ability to process eligibility applications effectively and in a timely manner,'” Gavin said in an email Thursday.

Some of the problems state workers identified, he said, included: complexity ensuring the state application for Medicaid matched with the federal exchange, delays in the release of key details about the exchange and “contradictory” advice from CMS about how the state should build its interface with the federal exchange.

The review comes as Republican Gov. Mike Pence is seeking approval from CMS to expand Medicaid using a version of the state’s Healthy Indiana Plan. If Pence’s request is approved, roughly 350,000 more residents could sign up for Medicaid coverage in the first few years of the program, climbing to above 450,000 residents by 2020.

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