HCRCC Entry to Coverage Workgroup--Final White Paper Comment Ltrx

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October 27, 2010 John Folkemer, Co-Chair Deputy Secretary, Department of Health and Mental Hygiene - Medicaid Brian Wilbon, Co-Chair Acting Secretary, Department of Human Resources Entry into Coverage Workgroup Health Care Reform Coordinating Council Dear Co-Chairs Folkemer and Wilbon: On behalf of the 67 members of the Maryland Hospital Association (MHA), I am writing to comment on the draft White Paper issued by the Entry into Coverage Workgroup. Many good points have been raised regarding the Medicaid eligibility process, including the need for a simplified system that is more applicant-friendly and less cumbersome. There will, however, be three primary challenges to implementing these recommendations: ensuring that sufficient funding is identified to pay for a modified system; the need for an open and transparent RFP process so that a variety of proposals can be considered and commented on by the state and community stakeholders; and maintaining a modified system that works effectively. We have circulated the Workgroup’s draft White Paper among hospital representatives who are frequently involved in the Medicaid eligibility process at their respective hospitals. Feedback has been summarized as follows: • The existing eligibility process has been likened to gate keeping. Those applying for eligibility must fill out voluminous forms and supply endless amounts of personal documentation. The population most likely to need Medicaid ...

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• Publié par: Kinuc
• Nombre de lectures: 11
• Langue: English

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October 27, 2010

John Folkemer, Co-Chair

Deputy Secretary, Department of Health and Mental Hygiene - Medicaid

Brian Wilbon, Co-Chair

Acting Secretary, Department of Human Resources

Entry into Coverage Workgroup

Health Care Reform Coordinating Council

Dear Co-Chairs Folkemer and Wilbon:

On behalf of the 67 members of the Maryland Hospital Association (MHA), I am writing to

comment on the draft White Paper issued by the Entry into Coverage Workgroup.

Many good

points have been raised regarding the Medicaid eligibility process, including the need for a

simplified system that is more applicant-friendly and less cumbersome.

There will, however, be

three primary challenges to implementing these recommendations:

ensuring that sufficient

funding is identified to pay for a modified system; the need for an open and transparent RFP

process so that a variety of proposals can be considered and commented on by the state and

community stakeholders; and maintaining a modified system that works effectively.

We have circulated the Workgroup’s draft White Paper among hospital representatives who are

frequently involved in the Medicaid eligibility process at their respective hospitals.

Feedback

has been summarized as follows:

•

The existing eligibility process has been likened to gate keeping.

Those applying for

eligibility must fill out voluminous forms and supply endless amounts of personal

documentation.

The population most likely to need Medicaid services is the same population

least able to supply such copious amounts of information.

The process must be simplified

and transformed into an advocacy process in which the needs of these individuals are

determined based on simple information, such as name, address, date of birth, social security

number, and adjusted gross income.

•

Alignment of state and federal databases will be key to simplifying the eligibility process.

Social workers, whether stationed at the local health department, the Department of Social

Services, or the hospital, should be able to submit basic information into a database that will

in turn gather appropriate information from Vital Statistics, the Internal Revenue Service, and

the Office of Unemployment Insurance, to name a few.

It should be noted that any

automated data collected from the IRS will be based on the previous year’s income tax

statement; this could allow some individuals to fraudulently take advantage of Medicaid and

prevent others who are truly in need from obtaining Medicaid eligibility.

Secondary

information from the Office of Unemployment Insurance will help alleviate potential

problems, but the issue still remains a challenge.

John Folkemer

Brian Wilbon

October 27, 2010

Page 2

•

As mentioned by others in the Workgroup’s public input process, a 12-month eligibility

status should be implemented to reduce administrative time and gaps in insurance for those

who find themselves cycling in and out of the insured population.

•

Implementing an expanded presumptive eligibility policy would maximize coverage options

and allow case workers to spend more time on complex eligibility applications, such as the

Aged, Blind, and Disabled applications, which currently require medical case review.

•

Documentation verification is a significant barrier.

Unfortunately, documentation is

necessary to prevent fraudulent activity.

However, many who would benefit from Medicaid

enrollment live transient lives and are unable to keep up with documentation.

Efforts should

be made to scan available documentation such as citizenship, income tax statements, birth

certificates, etc., so that documents can be shared among agencies to avoid delays in the

eligibility process.

•

The cost of designing and implementing an integrated eligibility system has not been raised.

In today’s strained economic environment, it will be difficult for the state to identify the

appropriate funding to establish a comprehensive system.

Consideration should be given to

designing an improved eligibility system that could be implemented in phases as funding

becomes available.

We appreciate the opportunity to provide these additional comments to the draft White Paper and

commend your continued commitment to improving Medicaid eligibility and enrollment.

Sincerely,

Valerie Shearer Overton

Senior Vice President, Legislative Policy