Feds intervene as wait times for Missouri Medicaid surpass 100 days

Aug. 11—JEFFERSON CITY — Waiting times for low-income Missourians seeking government-funded health insurance have gotten so long the federal government has had to step in to help.

The Centers for Medicare and Medicaid Services approved a plan July 11 to assist the state in reducing application processing times for the state's expanded Medicaid program. Those wait times have have stretched to more than 100 days.

The normal waiting time to be approved for MO HealthNet benefits should be no longer than 45 days, according to federal guidelines.

"Wow," said Sen. Jill Schupp, D-Creve Coeur, during a Wednesday meeting of the state's Medicaid oversight committee.

Like others, Schupp was surprised to hear the delays had grown rather than shortened after being assured by state officials earlier this year that they were on top of the situation.

"I just want to make sure we're really focused on getting that timeline down," Schupp told the panel.

After years of opposition from the Republican-controlled Legislature, Missouri voters approved a ballot initiative requiring the state to expand the Medicaid rolls to include more low-income adults.

Since the expansion began in October, more than 270,000 new applicants have applied for coverage. An estimated 34,000 are still waiting for their applications to be approved.

When voters approved the expansion, it was estimated that 275,000 would be eligible for the expanded coverage.

Kim Evans, director of family services at the Department of Social Services, said in June that processing times would drop to 45 days at the end of July and 30 days by the end of August. In March, waiting times were upward of 70 days.

Instead, the waiting times got worse, triggering the rare federal intervention.

The federal plan calls for putting some applications on a fast track for coverage. Workers also are being urged to enroll parents of children in Medicaid. Next week, the state will begin a series of weekly discussions with CMS to ensure the state is nearing compliance.

The goal is to meet the federal standards by Sept. 30.

Evans said the state has been working with federal regulators "really diligently" since last fall.

But as waiting times grew, CMS oversight became more intense. In May, the federal government sent a letter to the state raising questions about the delays.

Evans said the state was ready to respond.

"We started drafting the mitigation plan before we received the letter," she told committee members.

Evans expressed confidence that the state would solve the problems by the end of September. If the state misses the federal deadline, it could face financial sanctions for not being in compliance.

Schupp said the threat was a concern.

"We don't want sanctions. We don't want to lose money," Schupp said.

Among the challenges facing the Missouri Department of Social Services, which oversees the Medicaid program, are significant staffing shortages.

According to Gov. Mike Parson's Office of Administration, DSS is budgeted to have 6,600 workers but had only 5,600 as of July 15.

DSS previously said giving workers raises and offering overtime pay and other incentives for employees who are tasked with the applications will help lower the time it takes to process an application.

"We're throwing as many staff at this as we can," Evans said. "We will not let off the pedal."

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