Miss. Medicaid wants to continue recertification office visits

Published 1:19 am Sunday, December 9, 2007

Mississippi Medicaid officials insist a 2-year-old program that requires recipients to go to a local office to be recertified for benefits weeds out fraud, reduces costs and helps them better serve the needy.

Some say what’s been eliminated are thousands of the poor, elderly and disabled who have lost their only source for medical care.

A few lawmakers predict the policy may become a casualty in the legislative session that convenes next month even as Medicaid director Robert L. Robinson continues to defend it.

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“The face-to-face re-determination is one of the best things that we’ve got going,” said Robinson.

The face-to-face eligibility determination process began in 2005. Before then, people could be recertified for the Medicaid program by mail.

Medicaid has 30 regional offices and 60 satellite offices for people to apply for the program. Advocates argue that many of the people trying to enroll have trouble with transportation.

Compounding the problem are limited operation hours at satellite sites. In some cases, the offices aren’t open at all, said Jason Pollan, an attorney with the Mississippi Center for Justice.

Pollan said he visited all of Medicaid’s offices as part of a report about the effectiveness of the face-to-face policy.

Pollan appeared this past week at a state Capitol meeting attended by Robinson, lawmakers and social activists called by House Public Health Committee Chairman Steve Holland. Holland, D-Plantersville, said he wanted to hear about cost-saving ideas for Medicaid, which is facing an $86 million shortfall in the current fiscal year.

Before the meeting was over, tempers flared and Holland said the time had come to scrap the eligibility program.

“I’m more interested in health care and ya’ll would be better served to spend your time doing something else rather than trying to chase 2 percent of the population that might be wrongly on Medicaid,” Holland told Robinson.

Robinson said it was more mixed messages from lawmakers.

“You’re saying go get people, put them on Medicaid and then you’re cutting my (budget) request,” Robinson said.

Medicaid officials estimated that over a 20-month period ending in December 2006, the program saved nearly $203 million with the recertification program. The figure is based on 78,000 people taken off Medicaid and other factors, said Medicaid spokesman Francis Rullan.

Robinson said the reduction was due to more rigorous verification of applicants.

Robinson said the face-to-face meetings give families the opportunity to interact with Medicaid representatives who can inform them of other programs and help them find a permanent place to receive medical care.

“It’s much better than sending a cold letter,” said Robinson. “Some people have reading deficiencies and they don’t understand quite as well and some refuse to read letters.”

Many states have stopped using in-person meetings because “they recognize the difficulty involved in this population,” said Mary Kahn, a spokeswoman for the Centers for Medicare and Medicaid Services.

Dr. Tami Brooks, the legislative chairwoman for the Mississippi chapter of the American Academy of Pediatrics and the operator of a Jackson clinic, said every day she sees a new patient who’s no longer insured because the child lost Medicaid or state Children’s Health Insurance benefits. Medicaid oversees the joint state and federally funded CHIP program.

Brooks said some parents say they never received notification about an eligibility appointment. When they’re dropped, there’s a lengthy process to be reinstated, Brooks said.

“They show up here sick because they run out of their medication or they go to the ER because they have an asthma attack,” she said.

State Sen. Terry Burton, R-Newton, vice chairman of the Senate Public Health Committee, said he’s opposed to eliminating the Medicaid policy.

“A person gets on Medicaid because they have a face-to-face meeting. It seems to me they can have a face-to-face meeting to stay on Medicaid,” Burton said. “Maybe we need to have some flexible hours, some additional places where people can qualify.”

Pollan said his research shows that of 52 counties without full-time Medicaid offices, 85 percent offered three days of service or less per month. He said 18 counties had no service, including Sunflower, Tallahatchie, Carroll and Yalobusha, all in the Mississippi Delta.

Pollan said he went to a satellite office in Leakesville and workers there asked how he found the place.

“’How did you find us?’ isn’t the first words for service,” Pollan said.

Robinson said Medicaid cannot afford to man all satellite offices eight hours a day. He said some health facilities that provided space for Medicaid satellite offices have since asked them to close.

“We have to have a private space to interview these people. It crowds their waiting room. It is somewhat of a burden on that group who has invited us in,” Robinson said.

Medicaid, working with the state Department of Health, will open 27 more satellite sites in January, Robinson said.