BOSTON — About a half-million people are regaining Medicaid coverage after the federal government says they were dropped inappropriately by 29 states, including Massachusetts.
Officials say an “automation glitch” in the state computer systems didn’t properly evaluate people’s eligibility after the end of the coronavirus pandemic. Most of the impacted parties across the country were children, according to the Centers for Medicare & Medicaid Services. However, this was not the case for the Bay State.
A spokesperson from the Executive Office of Health and Human Services (EOHHS) says MassHealth is in the process of reinstating 4,851 members because they did not receive a fully compliant autorenewal, and none of these members were children.
States often use computer programs as a first step in determining whether people should be automatically re-enrolled in Medicaid. If their eligibility is unclear, states then attempt to contact people by mail, phone, text, or email seeking additional information. If that doesn’t work, people are dropped from the rolls in what CMS describes as a “procedural termination.” In late August, federal Centers for Medicare and Medicaid Services warned some state computer systems were flagging entire households for further information — and dropping all family members when no one responded, instead of reviewing each individual separately.
Such was the case in Massachusetts, where residents were deprived of some Medicaid coverage because their household did not respond to a renewal form.
EOHHS says MassHealth has a robust process for conducting autorenewals and has received federal approval to make additional enhancements to its systems, enabling it to automatically renew more members. MassHealth is also finalizing short-term enhancements to this system’s autorenewal process. This will allow a significantly higher number of members to be auto renewed.
State health officials say MassHealth will make long-term changes to its system to fully comply with the CMS guidance to avoid future problems.
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