COLUMBUS — State officials are working on a plan to resolve a backlog of more than 70,000 applications from poor and disabled Ohioans seeking Medicaid benefits.
Medicaid Director Maureen Corcoran said the number of pending applications has dropped about 30 percent in recent months, but federal regulators remain concerned.
“They have indicated that we are not in a position we need to be in, and they expect more dramatic resolution of this so they have asked us to put together a plan," Corcoran said.
The state is working with Franklin and other large counties “to diagnose what’s causing the backlog, how can we fix the system, how can we automate stuff," she said.
The delays — most applications have been pending more than 45 days — are causing people to wait to receive health care and creating financial burdens for some providers like nursing homes caring for residents unable to pay.
Officials with the federal Centers for Medicare and Medicaid Services declined to comment.
Advocates for the poor and uninsured say the backlog is concerning and commended state efforts to address the issue.
“Access to health care stabilizes individuals and families and allows them to take care of other basic needs," said Kelsey Bergfeld, coalition manager, Advocates for Ohio’s Future.
"Though the department has a responsibility to ensure eligible consumers’ needs are being met as quickly as possible, we understand that a significant number of people on the backlog are receiving care through presumptive eligibility, and the department has made substantial progress in addressing the backlog in the first few month of this administration ... and are optimistic the department will take steps to ensure this build up will not happen again.”
The state's Medicaid program covers about 2.8 million Ohioans. Under federal guidelines, applications for coverage and annual renewals to maintain benefits must be processed within 45 days for nondisability requests and 90 days for disability ones.
Before applicants can be approved, county caseworkers must verify their income, and for those seeking long-term care, they also must identify assets going back five years.
Corcoran said there are many factors contributing to the backlog, including the state's new online eligibility system and high turnover among caseworkers.
Kate McGarvey, executive director of Ohio State Legal Services, said advocates have urged the state to simplify the application process within federal guidelines.
For example, one idea would be to allow beneficiaries to be automatically renewed if the online system is able to check required information like an individual's income through tax returns or other accessible data. The beneficiary would then be sent a notice to verify instead of having to submit documentation to caseworkers.
It is not uncommon for individuals to lose benefits during the annual renewal process and then get them back once caseworkers confirm their continued eligibility.
State lawmakers raised concerns about the backlog last week when Corcoran testified before the House Finance Committee on Gov. Mike DeWine's budget proposal. She made clear that the problem predated the new administration.
“Unfortunately, that’s another one of those things I’m having to clean up," Corcoran told legislators. "We have been notified by the Centers for Medicare and Medicaid Services that they’ll be putting us under a plan of correction for this because it has not been remedied."
At one point last year, the backlog was nearly 110,000. In March, it had dropped to 88,000 pending applications.
"Those are numbers that are unacceptable," she said. "This is not a new problem but one which was left unattended to, so our first objective is, first of all we are not going to blame the counties.”
She said agency is working closely with County Job and Family Services Directors’ Association and urban counties, which have the largest backlogs.
“We’ve brought on some assistance and will be working with several of the counties to pilot how to do this better. ... Once we get this caught up, we can’t afford to end up back where we were. It’s causing a great deal of pressure on the counties as well as causing people to wait unacceptably long amounts of time.”