Ellington

A new program requiring face-to-face meetings for Medicaid recipients has contributed to over 55,000 children being dropped from state rolls. At a meeting of the Legislative Budget Committee last Thursday, Bob Robinson, executive director of the state's division of Medicaid, presented the agency's proposed budget to legislators and lauded the reduction in rolls for the money it had saved the state.

The new re-certification process, which began last year, requires Medicaid recipients to prove their eligibility in a face-to-face meeting with a case worker. In past years, recipients only had to fill out a form and return it to the state. Under the new program, recipients are sent one letter informing them of the requirement. If they fail to make the appointment, they are dropped from Medicaid.

Few states use such a demanding procedure. In fact, Pam Shaw of the Children's Defense Fund says that Mississippi is the only state that requires face-to-face meetings for both entry into the program and re-certification. At the committee meeting, Robinson said he believes that 10 states require face-to-face meetings for re-certification.

The proposed budget calls for approximately $530 million in state general funds as part of an overall $4 billion budget, the majority of which comes from the federal government. The $4 billion budget represents a reduction of around $500 million last year, the first reduction since at least 2000. The savings come from $275 million in pharmaceutical savings, largely resulting from last year's measure restricting Medicaid recipients to no more than two brand-name and two generic prescriptions, along with the reduction in Medicaid rolls.

At the meeting on Thursday, House Public Health and Human Services Committee Chairman Steve Holland, D-Plantersville, asked whether recipients had simply been dropped from the rolls because they missed their meetings.

"It's a combination of factors," Robinson replied. "Some have higher income. They're no longer eligible or they have never been eligible in the first place."

Under continued questioning, however, Robinson acknowledged, "We have a lot of people who don't show up." Robinson said he believed that most of those dropped were adults.

State rolls, however, show that the CHIP program, which supplements Medicaid, has 8,271 fewer children enrolled than in January 2005, while Medicaid has 46,684 fewer children enrolled.

Shaw said that the re-certification process is an unnecessary burden on working families. "There are 30 Medicaid regional offices where people can have these meetings," she said, "but we have 82 counties in Mississippi. So you have working people having to get transportation, take time off work and drive across counties in some instance just to recertify. They've already proven once that they're eligible."

Shaw also worries that many recipients are receiving sufficient notice of the required meetings. "I talked to a woman the other day who was given only 12 days' notice. You have longer than that to pay your bills," she said.

"It's one of those situations where theory and practice are night and day," Holland said this Tuesday. "I think where we are now is that the recertification process has an attitude problem. They're using it to cull people from the rolls instead of really determining eligibility."

Holland expressed concern that as the rolls were being reduced, the state had virtually ceased outreach to bring eligible children into the program.

"Doctors are telling us that they're seeing more children showing up in emergency rooms without insurance," Shaw said. "So how do you want to spend your money, prevention or emergency care? Fewer and fewer children will have insurance under this program, and we will all pay for that in the long run."

Previous Comments

ID

66904

Comment

this is just not acceptable. and I haven't seen one comment. CHIP is a good program, I'm not sure how much the state has to contribute but most is federal money. It just has to be handled well, and not by making people drive all over the state looking for an office to fill out paperwork. No kid left behind , I know that's education, left behind there too. (left behind, that phrase..never mind.) Everyone needs basic healthcare, CHIP is only for kids, but it's a start. It works in most states, what's up here? It's like the gov just begrudges anyone to get anything.. maybe Miss. is a test market for that. Let's support the Children's Defense Fund, and even Rep. Holland (he's not perfect but) . Kids can't wait, and they don't have to. Ok, I'll go do some research on CHIP, or maybe y'all can. (If you have recently , sorry, I don't get to read everything right away.)

Author

sunshine

Date

2006-10-11T14:36:20-06:00

ID

66905

Comment

It's Title XXI of Soc Sec Act http://www.aap.org/advocacy/schipsum.htm#stat read it and weep. well, read it and do something. states can do what they choose to do with it. (as some may know from prev. posts, I am from Minnesota, where there is a decent CHIP program, and a fierce Children's Defense Fund - and there's a Rep. governor who can't make a dent in that because it has so much support, as does the other low income health insurance program. I realize Miss. cannot afford all that, but it can afford CHIP , damnit. sorry, not. )

Author

sunshine

Date

2006-10-11T15:05:34-06:00

ID

66906

Comment

What do you expect? Robinson BY LAW is not qualified for his job. Slander? no. Here is the law: The Governor shall appoint a full-time director, with the advice and consent of the Senate, who shall be either (a) a physician with administrative experience in a medical care or health program, or (b) a person holding a graduate degree in medical care administration, public health, hospital administration, or the equivalent, or (c) a person holding a bachelor's degree in business administration or hospital administration, with at least ten (10) years' experience in management-level administration of Medicaid programs, and who shall serve at the will and pleasure of the Governor Robinson has a PhD in Business Administration. Cleraly that fails all three parts of the law that lists the qualifications. Now he DID run the Department of Public Welfare a long time ago. It was the forerunner to Medicaid but it had NOTHING to do with health care. DPW was in charge of administering ALL federal welfare programs in the state. The law also does not say that experience in DPW could be subsituted for experience in Medicaid. The law is pretty clear. The Director should be someone with health care administration or Medicaid experience. Robinson is not qualified and was snuck through the Senate right after Katrina. First thing that needs to be done is to replace Robinson.

Author

Kingfish

Date

2006-10-11T15:17:41-06:00

ID

66907

Comment

If Haley Barbour doesn't give a damn whether these kids get educated or fed, why would he give a damn whether they get medical care? His statewide platform is little different from what the White Citizens Council did to Leflore County in '62--no surprise, given who his mentors and donors were. If it were up to him, these poor kids would be dead and gone already. Firing Robinson would be a good first step, but I think the decision came from Barbour. Peace, TH

Author

Tom Head

Date

2006-10-11T16:02:58-06:00

ID

66908

Comment

("his mentors and donors" --> "some of his mentors and donors")

Author

Tom Head

Date

2006-10-11T16:03:32-06:00

ID

66909

Comment

Gets better. His deputy director of Medicaid that just retired, Moody, had a worse record. He only had a 2 year degree and is a farmer from Louisville. Oddly enough, a democrat BUT he chaired a legislative committee for several years that oversaw Medicaid. that made him qualified of course. So you had two guys running Medicaid that were not even qualifed to run the department.

Author

Kingfish

Date

2006-10-11T16:09:32-06:00

ID

66910

Comment

King, if he doesn't have a medical degree, then why in the name of God did EVERYONE at the hearing call him "Dr. Bob"? I had to go look him up afterward just to figure out what his actual name was.

Author

Brian C Johnson

Date

2006-10-11T17:33:33-06:00

ID

66911

Comment

he has a PhD in Bidness Admin. That means you get called doctor. ;-) He also used to run DOTD.

Author

Kingfish

Date

2006-10-11T18:53:46-06:00

ID

66912

Comment

this is just not acceptable. and I haven't seen one comment. Hey, I had a post that was about three or four paragraphs long last week, and it's not here! No wonder I didn't get any reply notifications. My blog entry on Mental Illness Awareness Week also disappeared last week, so I guess there were some system glitches at the time. I don't remember what I said (I was so ticked) except for suggesting that if they're going to have face-to-face meetings, Medicaid should be sent to the homes of those who can't make it to the regional office. Auditors have to go to the healthcare providers' offices on a regular basis, so why can't the folks in Eligibility go to the recipients to help them get recertified? There needs to be a grace period all the way around because ANYTHING can happen (mail delay, inclimate weather, etc.).

Author

LatashaWillis

Date

2006-10-11T22:50:44-06:00

ID

66913

Comment

Okay, my post's still here. :-)

Author

LatashaWillis

Date

2006-10-11T22:55:48-06:00

ID

66914

Comment

Keep in mind one thing. When Barbour took office Medicaid had a 200 million dollar deficit. How should it have been attacked? On a side note, I do favor co-pays to some degree. Might only by 3 or 5 dollars, but I do favor a co-pay for medicaid.

Author

Kingfish

Date

2006-10-12T00:18:17-06:00

ID

66915

Comment

Devils Advocate Time: I have a feeling the reason for the face to face interview is to cut down on Medicaid Fraud. How hard would it be for someone to falsely apply for Medicaid without having to show up and prove who they are? Honest question.

Author

Kingfish

Date

2006-10-12T09:05:49-06:00