Medicaid Enrollees Should Expect Smoother Renewal Process

Meanwhile, the Oregon Health Authority continues to paint a misleadingly rosy picture of CCOs, giving them credit for improvements to childhood screening that are not the result of better care but better data collection.

Oregon Health Plan members should expect a smoother time renewing their Medicaid benefits this year, according to state officials who met in Salem Tuesday at the Oregon Health Authority’s OmbudsAdvisory Council meeting.

If members have recently been approved for food stamps, they’ll simply have to sign a form asking to have their Medicaid benefits renewed -- similar to the Fast Track program that enrolled about 135,000 people last fall. 

“Once you give us your information that’s needed for food stamps, we as a sister agency of the Department of Human Services should be able to use that information,” said Ellen Pinney, the ombudsman for the Oregon Health Authority.

If they haven’t recently been approved for food stamps, but are currently receiving Medicaid benefits, they’ll receive a document asking them to record their current income, and as long as they’re below the income threshold for their family size, they’ll be renewed without filling out the full application again.

“This will make it easier to serve people on the Oregon Health Plan,” said Pinney. “The key to prevent a full application is to send the form back.”

Still the process could remain confusing for some -- and the state has plans to make additional steps to contact enrollees and assist them with re-applying. In the past, Medicaid recipients had to resubmit their financial information more than once a year. “They haven’t heard anything from us. They are wondering what’s going on,” said outreach coordinator Jon McDaid. The state is still finishing up the edits on the form letters it plans to send out, likely in August.

New potential enrollees who are not receiving food stamps can of course still apply by filling out the full application. This can be done in a number of ways, but the simplest method currently is to fill out the PDF form on the website of Cover Oregon, whose representatives will determine eligibility and the recipient will be notified by mail. 

Starting Nov. 15, eligible members will be able to complete a fully electronic form on a new health authority website, but transition project director Tina Edlund has said the process will not be fully automatic, instead still relying on the U.S. Mail to notify applicants of their enrollment status.

Enrollment for individual health plans, unlike Medicaid, is currently closed, but people who do not qualify for the Oregon Health Plan but do qualify for insurance subsidies may still sign up on Cover Oregon if they have a change in life experience.  

Changes in life experience include a move into or around Oregon; additions or subtractions to the household or dramatic changes in income. For gay and lesbian Oregonians, a recent federal court ruling in their favor would also help them qualify, McDaid noted:

“Marriage equality is now the law of the land. That could be a qualifying event,” he said, adding  that if someone has any doubt if they’ve had a qualifying life event, they should attempt to apply.

Without a change in life experience, enrollment re-opens on Nov. 15, and Oregon consumers will be directed to the federal exchange -- www.healthcare.gov.

OHA Continues to Cook Numbers

At the same meeting, the Oregon Health Authority continued to mislead the public with its assessment of the coordinated care organizations, wrongly attributing improvements to childhood development screenings that resulted from better data reporting rather than providing better care to children.

Sarah Bartelmann at the health analytics office lauded the CCOs for increasing screenings by a whopping 58 percent, but that jump in statistics was largely because pediatricians are now recording screenings that had been conducted earlier, but were not always properly recorded in the 2011 baseline data.

Members of the state’s metrics and scoring committee had noted the data entry problem and the seemingly appalling rates of childhood and prenatal screenings in a 2012 article in The Lund Report.

The health authority’s newly titled director of health analytics, Lori Coyner, acknowledged the incomplete baseline data in a June interview with The Lund Report, but on Tuesday, Bartelmann continued to use the trumped-up numbers to support success at the CCOs for which the state has little to no evidence.

In the annual report on CCOs that the health authority champions before various groups, the state has also taken credit for an across-the-board reduction among CCOs in elective caesarean pregnancies before 39 weeks, despite an earlier push by Oregon hospitals that effectively stopped this medically unjustified practice that is not recommended for good newborn health.

Chris can be reached at [email protected].
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