The state Department of Community Health will reinstate the Medicaid benefits of 17,000 poor elderly or disabled people it cut off in a mass disenrollment this month.
State officials still believe they properly notified most of those people it was time to renew, and that those beneficiaries simply did not respond. But out of “an abundance of caution” they will restart the process, said Blake Fulenwider, the agency’s chief health policy officer.
“We take every single one of these cases extremely seriously,” Fulenwider said in an interview with the AJC.
That means that the 17,000 people who were cut off — and another 13,000 that were in line for cutoff for the same reasons — will be sent new renewal notices. Recipients must respond to those renewal notices.
If they don’t, they will be cut off again.
Attorneys for some of the people who lost benefits said their clients never received the notices. They were glad to hear Friday’s news.
“We are grateful that the state has seen this as such a priority that they have worked diligently to assure health care for the most vulnerable Georgians including the seniors and disabled,” said Vicky Kimbrell, a staff attorney with Georgia Legal Services, a nonprofit that represents clients across the state. “We will carefully monitor the benefits on behalf of our clients to assure that they receive these benefits.”
State officials are urging all Medicaid beneficiaries to check their accounts to make sure their correct address is listed for notices, especially those in the group of aged, blind or disabled people on Medicare.
“If we don’t get a response to the notice or if the notice is sent to an incorrect address, we have very little we can do on our end to track people down,” Fulenwider said. “It is absolutely critical that we have an accurate address of record in the system so we can assure that notices are properly delivered to where they need to go.”
Updating a mailing address or email address is up to the person covered, Fulenwider stressed. He suggested recipients do that through their Georgia Gateway computer account, or by going into a state office, or calling the Medicaid 1-877-423-4746 customer service line. The offices that handle that are the Department of Family and Children Services, or DFCS, under contract to DCH.
Kimbrell said that that her clients often have difficulty fixing problems through those methods, starting with the phone line. She hopes that the news of those difficulties will encourage the state to prioritize fixes to its customer service system for benefits.
“We are back to the issue of the ability of people to get through, through Gateway or the phones or their caseworker, to actually get the renewals done,” Kimbrell said. “We hope part of the process is the recognition that the state has to make sure that those pathways are accessible for everyone.”
The group of people affected in this disenrollment were generally on Medicare, but were so poor that they also received Medicaid to fill in the gaps that Medicare doesn’t cover, such as Medicare monthly premiums of more than $100, medications, and co-pays. The loss of Medicaid can cause a domino effect for them, lawyers said, causing them to miss other payments, and lose medical coverage and medical care, for starters.
State officials made the decision after the Atlanta Journal-Constitution first reported the mass disenrollment, bringing attention from across the country and questions from federal regulators at the Centers for Medicare and Medicaid Services.
The reinstatement won’t happen immediately. Doing the computer coding to make the patients’ accounts active again will take some time, said Fulenwider and Ed Potts, director of the Georgia Gateway System at the Department of Human Services.
“Top priority for us to get this done,” said Potts. “And we want to get it done right.”
The Gateway computer system started the problem, when it accidentally created a backlog of 30,000 cases for cancellation last year. Every month, thousands of people come on and off Medicaid. The 30,000 people should have been part of that regular flow, Potts said, after they didn’t respond to renewal notices. The computer should have generated an alert for a caseworker to review each case and end the account.
Instead, a glitch that started in October put such accounts in limbo. When the vendor for Gateway, Deloitte Consulting, fixed the mistake in January, the backlog was too big for caseworkers to review. DCH decided to terminate them.
Deloitte, DHS and DCH say they are “extremely confident” that notices were sent to all but 68 of those 30,000 people before they were scheduled for the mass disenrollment.
When Medicaid accounts are reinstated, all benefits will be restored back to June 1, they said.
“We feel that we are absolutely correct in the actions that were taken,” Fulenwider said. “But we do recognize that it could have caught some folks by surprise. And we want to take the steps that we can to help them revalidate and take care of benefits.”
WHAT TO DO
DFCS and DCH will send renewal notices to 30,000 people who were slated for cutoff. If they don’t respond, they will lose their benefits. (Many of them already lost their benefits, but those are being reinstated temporarily, so the renewal process can generate again.)
Check your account
If you’re on Medicaid, just to be safe, check your account. Make sure you have the correct mailing address and/or email address on file so they can reach you. Look through your notices to make sure you don’t have any warning notices sitting there, whether or not you think you should have them.
If you see something amiss, or you just want to check, contact or go to DFCS.
If you get a renewal notice
Immediately follow the instructions and renew, through your Gateway account or the other options listed. There is a deadline for this and you need to meet the deadline.
DFCS says it’s working hard to get the mass disenrollment reversed. At that time, all 17,000 disenrolled people will have benefits reinstated dating back to June 1. It’s going to take a few days at least, though, for DFCS’ computer vendor to get that work done.
After that, if you believe you are still cut off from Medicaid in error, the state Department of Community Health says you have 10 days to appeal the decision. After that, the DCH says you can apply within 90 days for renewal at the local office that serves your county — that will be a Department of Family and Children Services office, not a DCH office.
The main customer service number for Medicaid is 1-877-423-4746. County offices have their own phone numbers, listed at https://dfcs.georgia.gov/locations.
Outside legal help
DCH and DFCS tell people in notices that if they believe they are wronged, they can call specific legal offices. The offices don’t take every case. But they do take cases where it looks like the state has done something wrong and the lawyers can help fix it and make a difference.
One group of lawyers helps people in parts of metro Atlanta, and the other group helps people in the rest of the state.
Atlanta Legal Aid
Atlanta Legal Aid helps people in these counties:
Cobb County: 770-528-2565
DeKalb County: 404-377-0701
Fulton County: 404-524-5811
Gwinnett County: 678-407-6469
South Fulton and Clayton counties: 404-669-0233
Georgia Legal Services Program
Georgia Legal Services helps people in all the other counties.
On June 6 the AJC first reported that the state cut off Medicaid for 17,000 poor elderly or disabled Georgians, and that some were saying it came without notice. The AJC later reported an additional 13,000 were in line for cutoff next, though the state was reconsidering. State officials say they verified that all but 68 received notice.
On June 14, the AJC reported bureaucratic glitches the patients were running into.
On June 21, following public interest and concern from federal regulators, the state said it would reinstate Medicaid for all 30,000 slated for cutoff, and go back through the renewal process with them.