Policies ending, 47,000 are told

State conducting Medicaid checks

More than 47,000 private-option enrollees and other Medicaid recipients are set to lose their coverage as a result of the check of recipients' incomes that began last month, a spokesman for the Arkansas Department of Human Services said Monday.

Coverage will end for about 33,000 recipients on Saturday and for about 14,000 on Sept. 1, Human Services Department spokesman Amy Webb said.

The first round of annual income checks began in mid-June -- about eight months after they were first scheduled to start -- for Medicaid recipients who had been enrolled for at least a year and whose eligibility is governed by rules that went into effect Jan. 1, 2014, under the 2010 Patient Protection and Affordable Care Act.

Since then, the Human Services Department has been using its partially completed electronic enrollment and eligibility verification system to check the incomes of thousands of Medicaid recipients each day.

By Oct. 1, the department expects to have checked the incomes of about 600,000 recipients, including children covered by ARKids First and about 200,000 low-income adults covered by the private option. Medicaid pays the premiums of private-option participants.

Of the 283,283 recipients whose incomes had been checked as of Monday, 63,326 were found to be eligible, and 1,371 were found to be ineligible, Webb said.

The 47,575 recipients whose coverage is set to be terminated include those found to be ineligible, as well as 46,204 recipients who failed to provide records proving their eligibility.

The remaining enrollees who were checked are receiving requests from the department for pay stubs or other records related to their incomes.

The department sent notices requesting such records from recipients whose incomes had changed by at least 10 percent since they were first approved for coverage.

Recipients were given 10 days to respond. Those who failed to respond within 15 days were sent termination notices, Webb said.

David Dundee, a Conway insurance agent who has helped about 300 clients enroll in the private option, said he's concerned that some enrollees will lose their coverage Saturday even though they remain eligible.

At least 10 of his clients sent in the requested information but still received notices informing them that their coverage will be canceled, he said.

"I have every reason to believe that they still qualify," Dundee said.

Sen. David Sanders, R-Little Rock and a sponsor of the law creating the private option, said he's advocated for enrollees to be given more than 10 days to respond to notices.

He cited problems with the electronic enrollment and verification system and a lack of staff at the Human Services Department to respond to enrollees' inquiries.

Federal officials give people enrolled in non-Medicaid coverage through the state's insurance exchange as long as 90 days to provide information, he said.

"We need to make sure that we're doing everything right on the state side," Sanders said. "It would be very unfortunate for someone to lose coverage due to an error on our side rather than on the individual's side."

Webb said Gov. Asa Hutchinson asked legislators during a conference call last week for feedback on the idea of giving Medicaid recipients more time to respond to the department's notices.

Hutchinson spokesman J.R. Davis said the governor doesn't plan to extend the deadlines.

"He has received feedback from a number of legislators, and they are supportive of the current plan and are willing to monitor it," Davis said.

Webb said recipients who send in the requested records within 10 days shouldn't receive a termination notice.

Arkansas created the private option to expand Medicaid coverage, as authorized under the Affordable Care Act, to Arkansans with incomes of up to 138 percent of the poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.

Citing concerns about the program's cost, Hutchinson has called on a legislative task force to recommend a program that would replace the private option starting in 2017, the year the state is expected to pick up part of the cost.

Enrollment in the private option began in October 2013 for coverage that started in 2014.

The Human Services Department is checking the incomes of about 350,000 private-option enrollees and other Medicaid recipients who enrolled through the new electronic system.

An additional 250,000 Medicaid recipients who enrolled through the older system will have their incomes checked after they are moved to the new system.

Human Services Department Director John Selig told legislators July 16 that about 75,000 of those recipients had been sent letters asking that they submit information to a Human Services Department office or through its website, access.arkansas.gov.

That information must be submitted within 30 days.

The eligibility checks were expected to start last fall but were delayed because implementing the electronic enrollment and eligibility system has taken longer than expected, department officials have said.

The officials have said they expect to have the checks completed in time to meet a Sept. 30 deadline set by the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services.

If a Medicaid recipient successfully appeals a termination, the coverage can be reinstated retroactively to the date of termination if the appeal is submitted within 90 days, Selig has said.

A Section on 07/28/2015

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