13,000 more Georgians could lose Medicaid benefits

Medicaid is run by the Georgia Department of Community Health. The DCH contracts with the Division of Family and Children Services to calculate applicants’ eligibility. PHOTO: Screenshot.

Medicaid is run by the Georgia Department of Community Health. The DCH contracts with the Division of Family and Children Services to calculate applicants’ eligibility. PHOTO: Screenshot.

State officials revealed that the full number of poor elderly or disabled Georgians they are slated to drop from Medicaid rolls is 30,000, much more than what they reported earlier this month. They say the Medicaid system sent out warnings to almost all of them, though, and received no response.

The Atlanta Journal-Constitution reported two weeks ago that the state Department of Community Health confirmed 17,000 Medicaid recipients were being cut off. The people are typically already on Medicare, but they are so poor they also receive Medicaid to fill in gaps such as paying the monthly premium for Medicare of more than $100, and paying for medications. The DCH said that the people in question didn't respond to regular annual renewal notices or termination warnings.

But lawyers for some of them said it was a mistake. They said their clients never received renewal notices, and they could prove that in their computer case files. In interviews, some of those clients told the AJC that after learning they'd lose their Medicaid they visited state offices and made calls to fix the problem — to no avail.

State officials now agree, in statements they provided to the AJC on Monday, that some people were cut off without receiving a renewal warning. But they said that amounted to only 68 people, not anywhere near the thousands that lawyers had feared.

The DCH will give the 17,000 who’ve already been cut off until Aug. 31 to renew their Medicaid. If they do that and they’re approved, they’ll receive back pay for their missed benefits.

But that wasn’t the full extent of the backlog: An additional 13,000 were in line for cutoff for the same reason.

Following the outcry, the DCH is now considering how best to handle them.

Lawyers for patients who are fighting the cutoff are skeptical that renewal notices really went out to 99% of the people as state officials said.

“I don’t see how that is possible,” said Alisa Haber, an attorney at the Georgia Senior Legal Hotline. She concedes she has no proof but points to the number of cases she and her colleagues are handling. “It’s not tapering off,” she said. “I think this is the tip of the iceberg.”

Another attorney recalled a previous case when the state’s vendor was supposed to mail out notices but didn’t.

Haber also doesn’t believe that if the state is willing to restore services, it is doing so in a way that people can navigate. Callers to the state Division of Family and Children Services mostly get recordings, not people, and may not have access to computers or cars to drive to an office. DFCS does the eligibility determinations under contract to the DCH. DFCS is short of workers and trying to hire 500.

DCH Commissioner Frank Berry said in a written statement that the state must remove those who are ineligible in order to serve those who are eligible.

“We are in the business of providing people support in their greatest time of need,” Berry said. “The best way to ensure we are serving the most vulnerable Georgians and are accountable to the taxpayer’s dollar is to ensure we are focusing resources on those who have established their eligibility for these programs.”

What no one expected, Berry included, was to cut off so many all at once.

The trouble began in the fall, when someone figured out that the state’s computer system hadn’t been sending alerts to caseworkers when a case was ready to terminate benefits.

For most types of Medicaid, the computer system was designed to automatically terminate cases. But state officials had decided that those receiving Aged, Blind and Disabled Medicaid were so likely to continue to be eligible that they would get special treatment — from humans instead of computers. Only caseworkers could terminate such a case after reviewing the file. The computer system would alert the caseworker to do that.

Then the system failed to send alerts. A backlog formed, a big one.

When the computer fix ran, 30,000 cases for renewal or termination were created at once, Ashley Fielding, a spokeswoman for the state department that includes DFCS, wrote in an email.

Because DFCS is short of caseworkers, it didn’t have the manpower to do manual reviews for all 30,000 cases and still meet its other deadlines.

“This was in addition to (caseworkers’) regular workload of processing approximately 30,000 to 40,000 renewals and applications on a monthly basis,” Fielding wrote. “DFCS immediately prioritized working on these tasks and granted overtime to staff to reduce the caseload,” she said. “But, due to the volume of terminations that would have to be done manually, DCH made the decision to terminate the cases through an automatic process.”

It hit the button to close 17,000 cases, and then 13,000.

Berry stressed, “We are working with our partners at DFCS to ensure applications for those most in need receive priority attention, and we will provide coverage retroactive to June 1 for those who renew their eligibility by August 31.”

In the future, Aged, Blind and Disabled Medicaid cases will still receive manual review before termination, state officials said.