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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

December 16, 2013 at 6:01 AM

Healthplanfinder glitches prevent Medicaid enrollees from renewing coverage

Washington residents hoping to sign up for new health-insurance coverage on Healthplanfinder are not the only people who have been affected by technical glitches on the website and the overloaded customer support center.

People who are currently enrolled in Medicaid are also running into problems on Healthplanfinder when they try to renew their eligibility, which they are required to do once a year to maintain coverage.

Normally, about 60,000 Medicaid recipients complete the renewal process each month, which involves reporting household monthly income and other personal information. But only about half that number renewed eligibility in November, the first month Medicaid recipients were supposed to use Healthplanfinder to recertify.

Medicaid officials are concerned that thousands of people who remain eligible for Medicaid were not able to recertify in November and were therefore dropped from the rolls on Dec. 1.

HCA Director Dorothy Teeter spoke about the problem at the most recent meeting of the board of the Washington Health Benefit Exchange, which operates Healthplanfinder. “We have a growing problem with folks that need to recertify,” Teeter said. “It’s a fairly significant issue.”

The HCA has been working on several fronts to help people who have been prevented from renewing because of problems on Healthplanfinder.

Teeter said the agency plans to ask the federal government for a waiver that would allow it to extend coverage by one month for enrollees unable to complete the renewal process.

The HCA is also working closely with the exchange to implement targeted fixes to Healthplanfinder that will help Medicaid enrollees overcome glitches.

Exchange CEO Richard Onizuka said at the board meeting that some Medicaid enrollees were running into problems if they entered information slightly different from the information that was already in the eligibility database.

“The problem has been that if the information doesn’t match perfectly, it produces an error code,” Onizuka said. “It could be something as simple as the system has them as Dan and now they’re putting in Daniel.”

So the exchange recently implemented a system fix that relaxed the rules to provide more flexibility.

Teeter said her biggest concern is that people who have been dropped from the rolls may not be able to get the care they need.

The HCA is communicating with health care providers and pharmacists in the state to make sure they are aware there is a 90-day grace period for Medicaid enrollees who are dropped from the rolls to renew their eligibility. During that period, enrollees can still get care covered by Medicaid.

“We’ve been saying to our providers and pharmacists, go ahead and take care of these folks,” Teeter said. “We’ll have a 90-day look-back, so you will get paid.”

Teeter said her biggest concern is that some health-care providers may not be aware of the grace period and therefore may not provide services to people who have been dropped from the Medicaid rolls even though they still qualify. “That’s my biggest worry,” she said. “We don’t want people inadvertently being denied care.”

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