The state’s plan comes in response to a blistering federal audit. Regulators seemed pleased by the effort, announced Friday by Medicaid Director Maureen Corcoran.

State officials released a plan Friday to tackle sweeping problems in the Medicaid program, including a backlog of nearly 19,000 applications from poor and disabled Ohioans seeking health coverage.

Medicaid Director Maureen Corcoran told federal regulators the number of applications pending for more than 45 days has been cut from 53,392 a year ago to 18,853 and should be down to 8,000 by July 1.

The state also is working on 129,465 cases that are past due for their annual checks to redetermine eligibility, including 47,056 packets returned by beneficiaries and waiting to be reviewed. Corcoran said the number of overdue renewals has dropped by half in the past year, and a plan for addressing the rest will be unveiled next month.

The tax-funded Medicaid program insures nearly 3 million people. Long waits in processing applications and renewals to ensure beneficiaries are still eligible for benefits can cause delays in receiving health care and cause hospitals, nursing homes and other providers to not get paid.

The state’s plan comes in response to a blistering federal audit released this week that found Ohio’s error rate for determining Medicaid eligibility was 43%, more than double the national average, along with a 50% error rate in Medicaid payments.

According to the audit, the Ohio Benefits computer system had nearly 1,100 defects, causing some applications to disappear, assigning incorrect renewal dates, and misplacing documentation needed to confirm eligibility. The findings do not necessarily mean benefits were provided in error, just that auditors lacked the information needed to verify the payments.

Federal regulators, who warned the state could face $6 billion in penalties, appear to be pleased with the state’s plan for addressing the problems.

“We appreciate the proactive leadership of Gov. (Mike) DeWine and his team to resolve these long-standing challenges,” Centers for Medicare and Medicaid Services Administrator Seema Verma said in a statement.

“Their steadfast commitment to program integrity will ensure we protect the most vulnerable of Ohioans. I look forward to working with them toward the successful implementation of their plan of correction, which will result in improvements to their systems and more accurate and timely eligibility determinations on behalf of Medicaid beneficiaries.”

Earlier this week, in anticipation of the audit’s release, Corcoran blamed the problems on the administration of former Gov. John Kasich. His eight-year tenure ended last January, when DeWine came to office.

In a report to DeWine, Corcoran said Medicaid, “as we inherited it, was a mess.” The federal audit reviewed Medicaid payments for the fiscal year ending June 30, 2018.

On Friday, Corcoran told The Dispatch much progress has been made in the past year, as evidenced by the reduction in the backlog and cases awaiting renewal.

The Department of Medicaid has added 25 employees to help county caseworkers process applications and is also working to correct computer problems. Corcoran could not say how much those efforts are costing taxpayers.

Corcoran said she believes Ohio Benefits can be fixed but it won’t be fast.

“It’s going to be a process that takes several years,” she said.


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Ohio Medicaid officials pledge to fix eligibility and backlog problems – Canton Repository