Automated systems involved in large-scale eligibility review are causing entire households to be removed from Medicaid coverage, but children may still be eligible
By Physician’s Briefing Staff HealthDay Reporter
THURSDAY, Aug. 31, 2023 (HealthDay News) — A Medicaid “glitch” is removing health care coverage for potentially millions of children, U.S. health officials warned Wednesday.
Automated systems involved in a large-scale eligibility review are causing entire households to be removed from Medicaid coverage, according to a news release from the U.S. Centers for Medicare & Medicaid Services (CMS), but children in the home may still be eligible based on family income even if their parents are not.
The eligibility review is happening now because a prohibition on removing people from Medicaid that was established during the pandemic ended this spring. During that time, Medicaid rolls of those provided coverage grew from 71 million to 94 million, the Associated Press reported. Now, states are returning to annual eligibility determinations. The process of determining eligibility can include using computer programs to review income and household information, including whether someone received unemployment benefits or food assistance, and sending notices asking people to verify their eligibility. Those who do not qualify or do not respond can be dropped by Medicaid. But most states allow children to have coverage at much higher household income levels than for adults, the AP reported.
In many states, “eligible kids are not being successfully renewed, and that is a violation of federal requirements,” Daniel Tsai, director of the CMS Center for Medicaid and Children’s Health Insurance Program Services, told the AP. CMS is giving states until Sept. 13 to report whether this glitch is happening in their states. They are being told to pause procedural terminations, reinstate coverage for those inadvertently dropped and find a solution to prevent this until the automated system is fixed, according to CMS.
Associated Press Article
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