• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Governor Axes State's 6-Month Recertification Rule for Medicaid

Posted on: Tuesday, 6 December 2005, 15:00 CST

By David Miles, The Santa Fe New Mexican

Dec. 6--Gov. Bill Richardson on Monday said he would order the state Human Services Department to require most Medicaid recipients to verify their eligibility for the health-care program every year instead of every six months.

The move marked the reversal of a policy implemented last year that required Medicaid recipients who were eligible for Medicaid because they had low incomes to recertify their eligibility every six months. Other Medicaid recipients -- such as the elderly and blind -- were not affected by the six-month requirement.

The change back to 12-month recertification will take effect in the fiscal year beginning July 1, said Richardson spokesman Gilbert Gallegos.

"This will keep children continuously insured longer, provide for greater continuity of care and get an additional 5,000 children the coverage they need to stay healthy," Richardson said Monday in prepared remarks for a health-care summit at The University of New Mexico Health Sciences Center in Albuquerque.

The 5,000 figure was the estimated number of adult and child Medicaid recipients who would be added to the state's Medicaid rolls due to the 12-month recertification change, said Human Services Department secretary Pam Hyde. The change would cost the state an estimated $4.5 million a year, Hyde said.

The governor's announcement caught some department officials by surprise. Hyde said she knew Richardson was considering the change but did not know he planned to make the announcement Monday.

Katrina Huffaker, spokeswoman for Santa Fe's La Familia Medical Center, called the more lenient recertification policy "really good news."

La Familia's caseworkers spent a lot of time helping their patients re-enroll in Medicaid after missing the six-month verification mark, Huffaker said. Some recipients said they never received a notice saying they would be taken off Medicaid while others complained they didn't understand the notice, Huffaker said.

"If they have to recertify once a year, that's a reasonable amount of time," she said.

Hyde said six-month recertification hasn't been burdensome on Medicaid recipients since people merely needed to mail a pay stub to verify their eligibility.

But Hyde also said reverting to 12-month recertification should make life easier for Medicaid recipients. "They just won't have to mess with it as often," she said.

Hyde said the six-month requirement was a cost-saving measure that also was aimed at ensuring only eligible Medicaid recipients remained in the program. Annual state general fund spending increases on Medicaid have dropped from nearly 16 percent in the 2004 fiscal year to a projected increase of just 2.5 percent in the 2007 budget year.

Earlier this year, department officials attributed a decline in the number of Medicaid recipients to a variety of factors, including the six-month recertification policy and another 2004 policy that automatically removed Medicaid recipients from the rolls if they did not recertify their eligibility.

Human Services Department officials also pointed to an end to outreach efforts that publicized Medicaid in 2002. The department has since launched new outreach efforts aimed at adding Hispanic and American Indian children to the state's Medicaid rolls.

The agency will keep its program to automatically close the cases of Medicaid recipients who do not recertify their eligibility with the 12-month verification requirement, Hyde said.

More than 10,000 Medicaid recipients who did not recertify were removed from the program last year, according to the department. However, 75 percent of those people had signed up for Medicaid within eight months as of September 2004, according to the department.

Hyde on Monday said the percentage of those returning to Medicaid has dropped since then, but she was not sure of the new figure.

The number of New Mexicans on Medicaid has dropped from a high of 430,535 in July 2004 to 411,069 this June. Medicaid enrollment is expected to bottom out at roughly 404,000 next month and then slowly rebound to roughly 430,000 in July 2007 as new outreach efforts take hold, according to department projections made prior to the 12-month recertification and other proposed policy changes.

Hyde said Richardson's other health-care proposals include:

Allowing Medicaid recipients to exempt more of their income for eligibility purposes. The Human Services Department expects the change to add roughly 7,800 children to New Mexico's Medicaid rolls at a state cost of $4 million a year.

Loosening income requirements for pregnant women seeking health care, with an annual state cost of roughly $3.8 million.

Providing tax credits for New Mexico businesses that have fewer than 10 employees and provide health insurance. The initiative would cost the state about $7.5 million a year.

New Mexico is expecting a revenue windfall of hundreds of millions of dollars next year, in large part due to higher than anticipated taxes and royalties on oil and natural-gas production.

Vernon Smith, Michigan's former Medicaid director, said economic conditions typically influence states' Medicaid changes.

"Now that state revenues are rebounding somewhat, states are looking at Medicaid as a vehicle to expand coverage or expand benefits," Smith said.

Smith conducts annual surveys of state Medicaid directors for the nonprofit Kaiser Commission on Medicaid and the Uninsured.

-----

To see more of The Santa Fe New Mexican, or to subscribe to the newspaper, go to http://ww.santafenewmexican.com.

Copyright (c) 2005, The Santa Fe New Mexican

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

Source: The Santa Fe New Mexican

More News in this Category