Some Pa. Medicaid problems attributed to paperwork lapses

Pennsylvania’s effort to clean up its Medicaid rolls has resulted in bitter complaints that some recipients have been improperly booted from the program.

According to the state Department of Welfare, about 71,500 children have been removed from Pennsylvania’s Medicaid program since August. That follows a directive to district office from a Harrisburg manager to comb through backlogs and shed ineligible people from the program.

Department spokeswoman Ann Bale says another 23,000 children were in “imminent danger” of losing eligibility.

But of those 23,000, said Bale, “rarely was the benefit ever stopped. It was just sort of a paperwork thing where they didn’t get us the paperwork and we said we’re going to have to close and then they got us the paperwork.”

In December, WHYY interviewed one woman who said the state lost her paperwork, and local aid groups say they’ve gotten many similar reports. Bale says she checked with program administrators and heard a different story.

“I hear that from outside sources but, internally, that’s not been the issue that’s been given to us,” Bale said. “It’s mostly clients who aren’t getting the paperwork to us in time. We don’t even look at it as an error rate. It’s just sort of a client compliance thing.”

There are many reasons a Medicaid case is closed — including a death or relocation. Bale said that a case is closed most often because a family’s finances change and the children are no longer eligible.

If a mistake has been made, clients have the right to appeal a termination, Bale said.

This story is part of a project on health care in the states, a partnership of WHYY, NPR and Kasier Health News.