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Case workers brace for flood of Medicaid applications


Case workers in area counties are gearing up for an influx of backlogged Medicaid applications that had been held up in the federal system for enrollment under the Affordable Care Act.

A series of technical problems with the federal system forced the state Medicaid department to wait until late February to receive 117,000 applications that were pending at HealthCare.gov — the federal website for enrollment in Medicaid and private ACA-compliant health plans.

After sorting through the backlog of applications from the federal website, which launched in October, Medicaid officials found 45,000 were duplicate applications that were already in the state system, and 39,000 were scheduled to be processed automatically on April 28.

The state will distribute the remaining 33,000 backlogged cases to case workers in each county for eligibility determinations and processing, with “high-caseload” counties, beginning to receive their share of pending cases in the week of April 21, according to Ohio Medicaid officials.

“We have very adequate staff to handle these cases,” said Kevin Lavoie, a spokesman for the the local Medicaid office, which has trained 234 case workers to handle the job. “They’re sending the cases out in manageable bites, so it doesn’t really look like and unmanageable wave of things coming down the pike for us.

“And, we think a number of those cases will have already resolved themselves through our encouragement of people to go through benefits.ohio.gov,” he said, referring to the state Medicaid benefits website.

Residents who may have applied through the federal system and then applied on the state site may already be in the system, according to Lavoie, who said Montgomery County has processed more than 12,500 applications since the state site went live in December. Butler and Clark counties have processed around 8,000 and 3,500, respectively.

Statewide, Ohio’s actuaries estimate 563,000 Ohioans are newly eligible for Medicaid under expanded eligibility requirements that extend coverage to anyone earning up to 138 percent of the federal poverty level — or about $16,000 for an individual, and 366,000 will sign up for coverage by June 2015.

Through the end of March, more than 345,000 Ohioans had applied for Medicaid coverage, according to the latest enrollment figures from Ohio Medicaid.

Of those applications, 225,574 – or about 65 percent – have been processed, with 180,877 individuals enrolled in Medicaid, and 44,697 determined ineligible for the state and federally funded health program for the poor, according to the monthly report.

The report did not include a county-by-county breakdown of those “newly eligible” for Medicaid, but 106,000 Ohioans statewide gained health coverage for the first time through the expansion of Medicaid, the report showed.

Ohio Medicaid officials estimate that most of the backlogged cases will be processed by May, and, at that point, “the department will conduct a more in-depth analysis to understand and report details about who enrolled,” according to a press release.


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