NH correcting glitch that caused people to lose Medicaid

Federal Medicaid officials announced Thursday that nearly 500,000 people nationwide have improperly lost their Medicaid insurance under what they called a “system glitch” that disenrolled people who remained eligible.

The Centers for Medicare and Medicaid Services did not report how many people were disenrolled in New Hampshire, but state Medicaid Director Henry Lipman told the Bulletin it was 3,176. About 1,350 of them were children, he said.

Each of those 3,176 Granite Staters are expected to have coverage reinstated by the end of this month, Lipman said. The state will compensate them for any Medicaid-eligible medical bills they incurred when they should have had coverage but didn't.

CMS warned states in an August letter that they would face “compliance action” if they didn't adjust their eligibility renewal process to ensure people were not improperly losing coverage.

Of the 20 states whose disenrollment numbers CMS released Thursday, two reported more than 100,000 of their residents were impacted. Ten states put that estimate at fewer than 10,000. Specific totals were not provided.

The situation pertains to “ex parte” eligibility reviews where states are required to use information they already have about a Medicaid holder to assess whether they remain eligible and automatically renew them if they are. The practice is intended to allow people who are eligible for coverage to keep it without having to go through what can be a complicated eligibility redetermination process.

But the process can overlook idiosyncrasies in individual cases that would have preserved Medicaid coverage, such as a child remaining eligible even if a parent was not.

CMS ordered all states in late August to immediately pause auto renewals until they could identify the procedures that were leading to improper disenrollments and correct them. States were also required to reinstate coverage immediately for those who remained eligible.

In a recent interview, Lipman said his office believed it had been complying with the CMS rules for eligibility redeterminations but learned it was not in line with the new federal guidance issued in late August.

In a press briefing Thursday, Daniel Tsai, director of the Center for Medicaid and CHIP Services, the federal children's health insurance program, declined to say how many children were among the estimated 500,000 who will see their Medicaid reinstated nationally.

Lipman said New Hampshire is now complying with the federal August directives and expects to reinstate coverage by the end of the month. The changes to its ex parte renewal process will also allow nearly 1,200 people who are up for renewal in October to keep their Medicaid, said Lipman.