*** UPDATED x1 *** Our sorry state
Friday, May 3, 2019 - Posted by Rich Miller
* Gov. Bruce Rauner deliberately slow-walked this process, but the Pritzker administration is in charge now…
As of March 15, more than 112,000 Illinois Medicaid applications remained unprocessed beyond the 45-day limit the federal government puts on those eligibility determinations.
The federal Center for Medicare and Medicaid Services has warned state officials that Illinois is out of compliance with regulations on timely determinations of eligibility for the federally funded program to provide health coverage for low-income people and asked how they plan to fix that, records show.
If a case is delayed past the federal time limit, Illinois Medicaid applicants are supposed to be able to get cards granting them temporary medical benefits. But those also are backlogged. The state’s Medicaid application-processing delays and failure to issue temporary medical benefits have left some of Illinois’ poorest residents without access to health care, in some cases for more than a year.
Illinois provided no temporary medical benefits at all between June 2016 and September 2017, state Department of Human Services records filed in federal court show. […]
Charlotte Brown, who works for Christopher Rural Health in southern Illinois, said most Medicaid applications in her part of the state are processed within two weeks but that it often takes months to get newborns added to their mothers’ Medicaid cases.
That’s just ridiculous. How would a newborn not qualify if their moms already did?
* Promises…
Jordan Abudayyeh, a spokeswoman for Gov. J.B. Pritzker, said: “It is unacceptable that people across the state are waiting for healthcare coverage, and he has directed the administration to take immediate steps to address this problem from the previous administration.”
In a written statement, the heads of the Illinois Department of Healthcare and Family Services and the Department of Human Services said: “Our departments are working together closely to bring on more workers to process applications and redeterminations, as well as training and technical experts to support front-line staff.”
*** UPDATE *** From Meghan Powers at the Illinois Department of Human Services…
We’ve made a lot of progress in the last two months and newborns are now being added to their mothers’ cases in a timely manner. We have eliminated the backlog of more than 26,500 newborn applications.
- wordslinger - Friday, May 3, 19 @ 10:38 am:
There seems to be a recurring theme that BPIA(TM) doesn’t have a firm grip on the levers of the executive branch.
It’s now May. Honeymoon officially long over. The boss needs to crack the whip and demand some accountability.
- Anon - Friday, May 3, 19 @ 10:54 am:
I want to know if they’ve fired Rauner’s agency level co-authors in this failure.
- Liandro - Friday, May 3, 19 @ 10:55 am:
Getting newborns onto military insurance is also a pain. Perhaps there are some analogous logistical issues for that particular family event?
- The_Equalizer - Friday, May 3, 19 @ 11:08 am:
Privatizing through Maximus was a miserable failure. Modernizing the computer systems through Deloitte (however badly updated systems were needed) ended up massively delayed and far over budget. Reducing the number of fraud investigators meant less fear of being caught for fraudulent applications. Doing all of this while ACA came online greatly increased the number of applications brought about a perfect storm of ineptitude that the system is still trying to absorb. Four years of a starve-the-beast “do more with less” Rauner mentality compounded problems. It might take years for the current administration to fix these issues, presuming it takes the correct steps.
- Fixer - Friday, May 3, 19 @ 11:12 am:
Part of the way is how the IES directs tasks. Part of it is the amount of time the system takes to do even the simplest tasks. And another part of it is staffing, be it levels or those who are not the most technologically educated that are having issues adapting to the new system.
A new app goes to a different set of workers than adding a newborn to a case (the addion of anyone to the household is considered a change, which is the largest backlog of work in the state right now).
The numbers have significantly improved over the last six months as system issues have decreased, but this isn’t going to be a quick or easy thing to address. I hope they investigate how this contract was awarded and get some better regulations in place so this doesn’t happen again.
- Honeybear - Friday, May 3, 19 @ 12:06 pm:
I second what Fixer said. And….
“but that it often takes months to get newborns added to their mothers’ Medicaid cases.”
Honestly, no, I hardly ever see this.
Newborns have got lots of appointments and Pediatrician visits.
Usually
The parent(s) call, come by the local office or go online and add the baby.
Rarely, very rarely does it take a long time to add.
If it is months
There’s a problem
They haven’t been doing their pediatrician visits.
Now down here in the metro east
We’ve got good clinics and hospitals that help keep folks on track.
The other reason why this is rare is that the size of household goes up with a baby.
Thus
Food stamps go up
Single woman Max stamps 192
with baby it goes to 353
That’s incentive folks
poor folk don’t often pass that up.
That being said
Yeah, we’re way behind.
for all the reasons Fixer said.
IES is over engineered.
What used to take 3 minutes can take 30
The system is getting less glitchie.
But usually the only time I see a baby not being added is when the parent
is not taking the baby in for visits.
When a parent brought a baby in several months old that wasn’t on the case,
I start asking a lot of questions.
Caseworkers are mandatory reporters and also trained against human trafficking.
- BPIA - Friday, May 3, 19 @ 12:07 pm:
more importantly, Wordslinger, can I get a Game of Thrones update?
- Been There - Friday, May 3, 19 @ 12:50 pm:
===That’s just ridiculous. How would a newborn not qualify if their moms already did? ====
If there is a father involved somehow and may not be married to the mother they may be investigating that. But you would think they would ere on side of getting the kid enrolled and if their investigation shows the daddy has some dough or insurance they could claw back.
- Honeybear - Friday, May 3, 19 @ 2:01 pm:
“We have eliminated the backlog of more than 26,500 newborn applications.”
Holy crap. Where were they keeping all those? I’m kinda stunned. Were those in some IES queue? Were they paper apps not datacapped? Oh my God people this makes me raging mad. Wow….well obviously we do have a problem. Sorry, my bad if I spoke out of turn. It wouldn’t be the first time.
- Fixer - Friday, May 3, 19 @ 2:44 pm:
Honeybear, nonindexed documents have been being manually routed a lot faster in the last few months now that they know datacap isn’t always routing things automatically That’s why that number is so staggering.