Thousands of Medicaid recipients will soon get alerts that they may no longer qualify for the health care program for the poor, unless they have evidence that proves they still meet the state’s eligibility requirements.
The 37,000 letters, which were mailed last week, are part of the Louisiana Department of Health’s efforts to clean up the state’s Medicaid rolls, after installing a new eligibility system and amid concerns about potential waste in the program.
Those who get letters will have 10 days to provide documentation that shows they qualify for Medicaid coverage, otherwise they will be removed from the program March 31.
“The Department’s new eligibility system gives us the infrastructure to better and more often verify the information that recipients are reporting. It is this information – financial and employment – that is crucial to being eligible or not for Medicaid benefits,” Health Secretary Dr. Rebekah Gee said. “Fortunately, our new online system allows recipients to log on and use the self-service portal. This is the quickest and most reliable way to make these important updates.”
A Louisiana audit that suggested there could be wide-spread Medicaid misspending has prompted a probe on the federal level.
Medicaid has begun adding quarterly wage data from the Louisiana Workforce Commission to its enrollment system, to help identify those who may make too much money to remain on the program. Previously, income checks were done annually.
LDH is urging Medicaid recipients to call the Medicaid Customer Service Line at 1-888-342-6207 to update their information.
Gee said it’s possible some of the people who receive letters will be removed from the state’s Medicaid rolls if they have gotten a new job or a promotion at work. “When the economy does better fewer people are eligible for Medicaid and that’s a good thing,” she said.
Louisiana now has one of the nation's most modern Medicaid enrollment systems — an undertaking that leaders say will help address concerns ove…
Those no longer qualify for Medicaid because of increased income will be encouraged to seek insurance through the federal Health Insurance Marketplace portal.
The Medicaid program that covers nearly 1.7 million Louisiana residents has faced increased scrutiny in recent years since Gov. John Bel Edwards, a Democrat, agreed to expand Medicaid through executive order shortly after taking office in 2016. More than 481,000 people, mostly the working poor, have been added to the state's Medicaid rolls through the expansion, which applies to adults whose household income falls below 138 percent of the federal poverty level, which is about $16,600 a year for a single person or $33,900 annually for a family of four.
Louisiana's health department may have spent as much as $85 million over 20 months for people enrolled in the Medicaid expansion program who d…
In the three years since the expansion took effect, the Louisiana Legislative Auditor has audited Medicaid at least nine times. According to the most recent one, LDH may have allowed up to $85 million to be spent on ineligible people during a 20 months period – largely because of the self-reporting standards for employment under the old system and also worker errors.
"Without a sufficient process to determine recipient eligibility, LDH cannot ensure that Medicaid dollars are spent appropriately," auditor Daryl Purpera concluded in his overview, which was presented to legislators last month.
The effort to move to a more standardized enrollment portal has been in the works for years. It cost about $71 million, 90 percent of which was covered by the federal government, and required weeks of retraining employees.
In the two years since Louisiana expanded its Medicaid health care program, more than 400 women enrolled have been diagnosed with breast cance…
The audit’s findings here prompted members of Congress from other states to seek information about whether other states need to be doing more to maintain their rolls.
U.S. Sen. Ron Johnson, of Wisconsin, and Rep. Jim Jordan, of Ohio, penned a letter last month to Centers for Medicare and Medicaid Services head Seema Verma, citing Purpera’s report as need for more information about whether there is a national Medicaid spending problem.
“If these improper payments are occurring in one state, it is logical to assume overpayments are occurring in other states,” the Republican congressmen wrote in the letter. “We respectfully request information about what the Centers for Medicare and Medicaid Services plans to do to determine where overpayments are being made, steps CMS will take to recover overpayments, and controls CMS will put in place to ensure federal Medicaid dollars are only paid to those who qualify.”
Purpera responded to the congressmen with a letter of advice and to offer his assistance if its needed for the federal review.
The Department of Health has the largest budget in Louisiana state government at $14 billion – more than 70 percent from the federal government. Its funding has ballooned with the expansion of Medicaid, which is nearly all covered by the federal government through the Affordable Care Act.