Officials dismayed by Medicaid backlog / LJWorld.com

Archive for Friday, June 1, 2007

Proof-of-citizenship rules reportedly preventing health coverage for Kansas kids

June 1, 2007

Topeka — State officials said Thursday that it will take seven more months to resolve thousands of cases involving Kansas children who lack health coverage because of federal proof-of-citizenship rules.

"We expect that backlog to be resolved by January," Connie Hubbell, chairwoman of the Kansas Health Policy Authority, told a legislative oversight committee.

Some lawmakers were not pleased with the report.

State Sen. Roger Reitz, R-Manhattan, a physician, said the federal requirements were "major, divisive elements that I think should not be allowed to exist."

State health officials have wrestled with the problem for months after Congress and President Bush adopted a law last year that requires Medicaid applicants to show proof of U.S. citizenship, through a birth certificate or other documentation.

The proof-of-citizenship measure was inserted in the federal deficit reduction law as a way to prevent illegal immigrants from getting benefits from Medicaid, the federal-state program that provides health care services to low-income people.

But state officials said the requirement has produced a backlog of 18,000 to 20,000 Medicaid applications. Many of those are eligible Kansans who don't have the necessary paperwork, they have said.

Marcia Nielsen, executive director of the Kansas Health Policy Authority, said states have been lobbying Congress so they can administer the citizenship requirements in their own ways.

"There is movement now in Congress to allow states to have their own methods," Nielsen said. "This was a horrendous lapse of judgment," she said of the federal law.

Among states, Kansas has been one of the worst affected because officials here followed the law so closely, Nielsen said.

At the time the law took effect, Kansas also was being audited by the federal Centers for Medicare and Medicaid Services over questionable spending practices. Those audits resulted in lawmakers recently allocating approximately $100 million and instituting numerous changes to satisfy CMS.

"We were following the letter of the law considering how much hot water we were in," Nielsen said.

But recently several other states also have found problems with the citizenship requirement.

KHA officials said funds approved by the Legislature will allow the agency to hire additional staff to manage the increasing workload at its Medicaid clearinghouse. Lawmakers approved $81,105 in state funds for the current fiscal year, and $623,731 for the next fiscal year, which starts July 1.

Discussion

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1 June 2007
at 6:56 a.m.

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Baille (Anonymous) says…

This administration has greatly increased the bureacracy and the backlog at Medicare in other areas as well.
1 June 2007
at 7:20 a.m.

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ASBESTOS (Anonymous) says…

“But state officials said the requirement has produced a backlog of 18,000 to 20,000 Medicaid applications. Many of those are eligible Kansans who don't have the necessary paperwork, they have said.”

How do they know they are eligible or not if they do not have the paperwork? That statment is intentionally misleading. The Department here is just blaming a Federal Rule for their own lack of motivation and production rates.

IF they do not “have the paperwork”, like basic ID, then they are “not” eligible”, as per STATE law!

“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”“”

“At the time the law took effect, Kansas also was being audited by the federal Centers for Medicare and Medicaid Services over questionable spending practices. Those audits resulted in lawmakers recently allocating approximately $100 million and instituting numerous changes to satisfy CMS.”

They deny why were they in “hot water”? They did not follow the law and had “questionable spending practices”, and we are supposed to believe this?
1 June 2007
at 8:10 a.m.

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abcd (Raymond Munoz) says…

I've said it before, and I'll say it again. In all my years working with Medicaid patients, I have not seen ONE instance where a non-citizen has even applied for, much less managed to get, Medicaid benefits. I'm sure it has happened in a few isolated instances, but for the most part, people that are here illegally do not even attempt to get Medicaid benefits for themselves. Sure they can get medical cards for their children that are born here, but I've even seen cases where a child born in Mexico that came over here at 6 months old does not have a medical card while a child that was born to the same parent 6 months later, only here in the United States, does have a card. The ONLY people that these new rules are hurting are children that are U.S. citizens whose parents just can't seem to find their birth certificate or just don't have the skills necessary to call up Topeka and get a copy. I've seen WAY too many kids losing their Medicaid coverage because of all this proof of citizenship hoopla, when it just wasn't a necessary step to take. It's all just political rhetoric to make people think that our elected officials are doing something about illegal immigration.
1 June 2007
at 8:42 a.m.

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common_cents (Anonymous) says…

I have to agree with asbestos on this one. And to think that non-citizens are not applying for benefits is silly… they are, they are getting them, and they know how to work the system better than U.S. citizens. Wake up.

“U.S. citizens whose parents just can't seem to find their birth certificate or just don't have the skills necessary to call up Topeka and get a copy”

They have the skills to call up or go down and apply for Medicaid, but they don't have the skills to call up or go down to get a copy of their child's birth certificate? Again, wake up. Are you trying to tell me, that illegals that can barely speak and read our language (if at all) have the skills to get a fake social security card, file taxes fraudulently, get a job illegally, and even buy property while being illegal - yet our own citizens are too stupid to call a state agency to get a copy of a birth certificate?

If that's the case, then we are already lost. Let the illegals in and deport those citizens who are too stupid to take care of their own lives.
1 June 2007
at 11:21 a.m.

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ljreader (Anonymous) says…

abcd- Just wondering- If an illegal alien were to present fradulent documents- a green card, a birth certificate, a stolen or forged social security number- do you have a way of verifying the authenticity of these documents?
If so, please share the process with employers who claim they have no way of doing so.
1 June 2007
at 11:36 a.m.

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pelliott (Anonymous) says…

It probably is easier for a legal citizen to use fraudulent documents, then everything could be in order. They are asking frail elderly poor to come to the offices and present documents every month to continue eligibility for food stamps, plus treat them like trash. The war on the poor is no war on proverty. Making sure a child doesn't recieve medical care by designing a punitive system rather than a workable one is not really where I want to spend my tax dollars for health, yet that is what is happening.
1 June 2007
at 11:43 a.m.

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ljreader (Anonymous) says…

pelliot-Why would an American citizen need to use fradulent documentation???
I believe it costs in the neighborhood of $12 to obtain a copy of a birth certificate- Not a bad investment to receive paid medical services-
It is FREE to receive a replacement for a lost social security card.
Doesn't seem punitive.

1 June 2007
at 12:17 p.m.

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crazyks (Anonymous) says…

$12 may not seem like much to you, but try having to shell it out, for multiple children, when you have an income of $500 a month or less.

And even if you have the money for the certified copy of a birth certificate, not everyone has cars and can just hop in and go to Topeka anytime they want. Probably most people who have to do this have to rely on snail mail to get the documents, and that takes time, usually 6-8 weeks. Why it takes Topeka that long to locate a document and send out a copy is beyond me.

I didn't think you could just call Topeka and ask for a copy. I thought you had to fill out a form first.

I was told by DMV that social security cards cannot be used for ID. They're too damn easy to copy, and don't have all the bells and whistles planted in them that a driver's license or state ID does. It's against federal law to ask someone for their social security card as proof of ID…so we should ignore federal law now?

And really, what difference does it make? Even if someone slips through that's illegal, so what? Would you rather they go to the ER for treatment, as most of them do now? That's much more expensive, you know.
1 June 2007
at 12:32 p.m.

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abcd (Raymond Munoz) says…

ljreader: I know that SRS has a way to verify wages and social security numbers, so I really don't know what prevents employers from using the same types of resources to check out information other than the fact that some employers just don't care and/or would rather have a cheap source of labor regardless of residency status. When I was working at KU Med with Medicaid patients, the SRS people seemed pretty adept at identifying people with stolen SS #'s. They'd bring up a list of 5-6 different people that were all using the same #. I always thought it was interesting that this same database wasn't being used by employers.
1 June 2007
at 12:34 p.m.

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Bubbles (Anonymous) says…

Make medical care free. That will reduce the paper work.
1 June 2007
at 12:56 p.m.

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ljreader (Anonymous) says…

Thanks for answering that question abcd- What kind of ID do you require (or will you accept) to determine citizenship status besides birth certificates?

Also I looked it up- The longest it should take to get a copy of a birth certificate is 7-10 days through regular snail mail-
15- 20 minutes for walk-in.
3 days through internet, phone, fax, priority mail-
http://www.kdheks.gov/vital/birth_how…
We've known about this for months- Anyone collecting medicaid have had plenty of time to get their paperwork in order- unless, of course, they are just now applying.
And it is $12-
Perhaps agencies could reimburse applicants the $12 fee if it is determined they are citizens, and if paying $12 is found to be a hardship (sliding scale?) - It would still be less expensive than paying medical costs for non-citizens. Yet, as Crazyks points out, the practice of illegal aliens using emergency rooms for basic medical care is expensive, too. Looks like we're stuck paying out the waazoo no matter what we do.
1 June 2007
at 1:06 p.m.

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ljreader (Anonymous) says…

“Perhaps agencies could reimburse applicants the $12 fee if it is determined they are citizens”,…

I just realized the stupidity of that remark- Anyone who doesn't have a legal birth certificate would not pay $12 to get a copy… because, obviously, they can't get a copy of something they never had to begin with.
-I meant to say- After they have confirmed their citizenship through legal documentation, perhaps they could be reimbursed for the expense.
1 June 2007
at 3:53 p.m.

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ASBESTOS (Anonymous) says…

“I've said it before, and I'll say it again. In all my years working with Medicaid patients, I have not seen ONE instance where a non-citizen has even applied for, much less managed to get, Medicaid benefits.”

Who the hell do you “know this” when there is no requirement to “show papers” now?

How do you “know” illegala aren't getting the benefits?

I do “know” that have been prosecutions for benefit fraud in just this situation with illegal aliens. It is in court records and agency records.

So it seems as if abcd doesn't know spit!
1 June 2007
at 9:31 p.m.

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abcd (Raymond Munoz) says…

Actually, being a dental project coordinator, I do know a thing or two about spit, asbestos. And while there may be prosecutions against illegals for benefits fraud, I *know* there have been many more cases against citizens. Look *that* up in your court records and agency records. In fact, just the other day, I had a perfectly good, upstanding, U.S. citizen fraudulently use a “borrowed” medical card to get some teeth pulled. People ARE required to “show papers” now which is why we're having all this mess with Medicaid having a backlog of 18,000 to 20,000 cases. And a lot of these cases involve the kids I try to provide dental care to. And when it affects my kids, it's personal. And I can tell you from *first hand experience* that every single one of the kids I've encountered that is having problems with their medical cards being taken away because of this proof-of-citizenship rule is a United States citizen, predominantly white, and from a family that is at 150% of poverty levels or below. Is it fair to these kids that a law to appease people like you was passed in order to prevent maybe a handful of non-citizens from getting medical benefits? I don't think so.
2 June 2007
at 11:58 a.m.

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rsmart (Anonymous) says…

These parents are given plenty of time to get the proper documents needed before their childs insurance expires. I think it is pure laziness on the parents part. This is your childs health coverage you are dealing with here. Get off your A's and do what needs to be done to keep your childs coverage. We are lucky to have benefits for our children as it is.
As far as having to prove citizenship I think it is a good idea, that way the benefits are going to our children and not a bunch of non-citizens getting a free ride. If we don't put restrictions on things we will end up not having any benefits for us US citizens because they will all be used up by the non-citizens.
Do it for your child.

2 June 2007
at 12:03 p.m.

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rsmart (Anonymous) says…

As for Medicaid being back logged, this is just another excuse. If they ae back logged because of this situation, then maybe they need to hire some temps to help get them out of their rut. “oh, but that would mean to pay someone who needs a job!” Never mind, bad idea.