Lawyers Claim Missouri Violates Federal Law, Courts Over Medicaid Expansion Delays

Lawyers who have successfully sued to force Missouri to pass a voter-approved Medicaid extension argued in a letter to state officials Thursday that the implementation delays not only violate the court order but also federal law.

Plaintiffs’ attorneys, Chuck Hatfield and Lowell Pearson, joined Joel Ferber, director of advocacy for Eastern Missouri Legal Services, in a letter to the Attorney General’s office asking why the Department of Social Services would need help. ‘a deadline until October 1 to start registering. eligible people.

The letter argued that refusing to enroll newly eligible people until October 1 when previously eligible people continue to have their applications processed “does not treat these populations fairly” as the court ordered.

The letter noted that complainants expect individuals to be enrolled in a timely manner and that federal Medicaid law requires claims to be processed within 45 days – with a few exceptions.

“Not only is the decision by the Family Support Division to withhold all applications until October 1 is a violation of the court order, but also a violation of federal law,” the letter read, which was also sent to senior DSS officials.

A spokesperson for the attorney general’s office declined to comment. A spokesperson for the DSS did not immediately respond to a request for comment.

Earlier this month, Cole County Circuit Judge Jon Beetem ruled that the DSS could not deny the approximately 275,000 newly eligible residents eligible for benefits as part of Medicaid’s expansion. register or impose more severe restrictions on them.

State attorneys had argued that the department needed an additional two months to set up the necessary staff and IT systems. Despite the court order, the state has consistently said it would take up to 60 days for necessary system updates to determine claim eligibility.

The Independent previously reported that lawmakers were told by DSS officials that the requests would not be processed until October 1.

This week, the St. Louis Post-Dispatch reported on an Aug. 11 video from the Director of the Family Support Division, Kim Evans, telling employees that the applications would remain “in place” until then. that system upgrades were in progress.

Later in the video, Evans also goes on to say, “We have turned off automatic denial because we need to accept these apps now.”

KJ McDonald, Joplin’s organization director and organizer for Missouri Health Care for All, said she spoke to a handful of Missouri residents who were eligible for benefits under the Medicaid extension and did a request between July 1 – when the Medicaid extension would go into effect – and before Beetem’s decision was made on August 10. Of those, some requests have been denied, while others are still pending, McDonald said.

“I think what’s happening on a larger scale isn’t very successful,” McDonald said.

McDonald said this has created confusion for residents about whether to reapply and anxiety for those who are waiting to have benefits in place before seeing a doctor to look at a problem. health.

Ferber said he understood that because there was no mechanism in place to approve residents eligible for the Medicaid extension before the court order, the requests received would have been denied.

“For the people doing the expansion, I think it probably would have been beneficial to them,” Ferber said of DSS withholding claims until the court decision instead of issuing denials. “It’s always better not to refuse (yourself), because that creates confusion.”

McDonald’s says residents who are having issues or have questions with their application should contact organizations like Cover Missouri or Missouri Legal Services for assistance.

“I think the bottom line from what I’ve heard from people is that people really need Medicaid,” McDonald said, “and they need it ASAP.”

DSS spokesperson Rebecca Woelfel did not confirm that the ministry automatically turned down applications as Evans said in the video. Woelfel said the Family Support Division will “reopen” applications received since July 1 and begin determining eligibility from October 1.

“These candidates have nothing to do,” Woelfel said. “The Family Support Division is currently verifying the information as a preliminary step that will eventually speed up the processing of applications. ”

Woelfel did not immediately respond to a request for comment on whether the division has sent notices to rejected or pending applicants to make it clear that no action is required on their part.

Evans told a MO HealthNet oversight committee meeting last week that the department was considering offering eligible applicants who apply through Oct. 31 automatic retroactive coverage to July 1.

Evans also said the division is making efforts to identify and verify information of current recipients of Medicaid services who may also be eligible for coverage as part of the Medicaid expansion. On Monday, a memo was released describing the division would notify potentially eligible people that they would be assessed for benefits under the Medicaid extension when claims begin to be processed.

In Thursday’s letter, lawyers said they were ready to brief the court on the developments. They asked state officials to clarify their decision to choose an October 1 listing date and to provide any communication documenting that decision.

They also called on the state to outline its compliance with the court order, inform the process of registering individuals, and explain whether changes to the state’s plan have been resubmitted to regulators. federal.

In an update from MO HealthNet’s provider on Tuesday, the division said it had posted the order and judgment on its website.

Last week, Kirk Matthews, acting director of MO HealthNet, said the state had yet to submit its amendment to the state plan and was working on the issues the Centers for Medicare & Medicaid Services had. on the state’s initial plan before its withdrawal in May.

Independent from Missouri is part of States Newsroom, a grant-supported media network and donor coalition as a 501c (3) public charity. Missouri Independent maintains editorial independence. Contact editor Jason Hancock with any questions: [email protected]

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