$134M system to speed benefits

Ohio rolls out its new $134 million simplified, Medicaid application process Oct. 1, hyped to determine eligibility in real-time, offering an immediate response to people applying online.

The speed of the new system comes from technology that automatically verifies income, citizenship and the identity of applicants by searching federal databases. The system “pings” or tags information such as employment status, income, social security numbers and birth dates. Data sources include the Department of Justice, the Social Security Administration, the Department of Homeland Security, Health & Human Services, the Internal Revenue Service and the United States Treasury.

“We are trying to simplify, as best we can, something that is not a simple system,” Joel Potts, executive director of the Ohio Job and Family Services Directors’ Association said.

The Affordable Care Act required states to develop a real-time, online application for Medicaid. So, the federal government picked up 90 percent of the cost for Ohio’s new integrated eligibility system, according to the state Department of Administrative Services. The state paid the $17 million balance. Ohio eventually plans to move all Health and Humans Services programs onto the integrated system, but that will take time.

“Ohio made the conscious and right choice to put all poverty programs on the same system,” Potts said. “Cell phones are obsolete in six months, laptops in a year. We were still using a legacy 32-year-old system with a massive mainframe.”

Last year, 2.3 million Ohioans had to physically meet with a county caseworker to apply for Medicaid and they were often required to make multiple repeat visits to a county office, according to the Ohio Office of Health Transformation. Effective Oct. 1, all Ohioans can apply for Medicaid at: www.Benefits.Ohio.gov.

“I think the biggest thing is one of convenience for folks,” Jerome Kearns, director of the Butler County Department of Job & Family Services said. “The days where you had to come into the office to make an application are over.”

A new “no wrong door” access policy means people can make the application via a cell phone, land line, a computer, electronic tablet or in person at a county job and family services department.

Initially, Ohio will only process Medicaid applications for pregnant women and families with children on the new system. Eligibility standards for those groups change Jan. 1 as a result of new standards mandated by the Affordable Care Act. The goal is for most enrollees to learn of their eligibility for Medicaid based on income tax information, without need to undergo any additional eligibility tests.

Virginia Martycz, acting director of the Department of Job & Family Services of Clark County, said 10 caseworkers have been trained on the new system, and ten more are learning.

“We are having training constantly,” Martycz said. “Once we get everything rolled out it will be much easier. At the moment there is so much uncertainty. I’m telling my staff to take each issue as it comes up and deal with it.”

All other applications for Ohio Medicaid will be processed under the existing eligibility system, for now.

“It’s ridiculous in this day and age that you can go out on your lunch hour and buy a $20,000 automobile, but if you go to a county job and family services department…it takes you 30 days to receive services,” Potts said. “There is something fundamentally wrong with a system like that.”

Dwayne Woods, Montgomery County’s Job & Family Services manager said there have been challenges with the aggressive timeline to meet technical requirements, as mandated by federal law.

“We’re hoping everything works out, but at this juncture we don’t know what it’s going to look like,” Woods said.

Information provided by applicants that doesn’t match federal data will be flagged for verification by the caseworker.

“It should absolutely cut down on fraud,” Potts said.

Eventually all of the state’s Health and Human Service programs will be transitioned into the self-service portal and the integrated eligibly system. The plan is to merge other Medicaid applications, food assistance and financial benefits programs onto the system by July of 2015.

In the meantime, caseworkers will be navigating the old and new systems.

“Ultimately, it will make us far more efficient than the way we process cases now,” Lauren Cavanaugh, director of the Division of Human Services for the Warren County Department of Job & Family Services said. “As with any kind of a quick rollout, we ask the public to be patient.”

Individuals who apply for Medicaid and are not eligible, will automatically be transferred to the federal Health Insurance Exchange. And, individuals who apply for health care through the federal exchange (www.HeathCare.gov) but may be eligible for Medicaid will have their applications transferred to the Ohio Integrated Eligibility System.

“The end goal is that the process will be simplified for the person applying and the county processing the application,” Beth Rubin, director of the Greene County Department of Job & Family Services said. “We’re in training right now. There is no shortage of work. We don’t know what the workload is going to look like. We don’t know what to expect.”

To see Ohio Medicaid Eligibles and Expenditures Report, click here .

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