State scrambling on Medicaid rules

Posted March 12, 2014

— State Department of Health and Human Services officials are asking federal Medicaid officials for a waiver due to continuing issues with NC FAST, the state's new benefits management program. 

Under the Affordable Care Act, all states were required to recertify all Medicaid recipients and applicants under new income guidelines as of Jan. 1. North Carolina already received one three-month extension, making the state's new deadline April 1. 

The new guidelines, called Modified Adjustable Gross Income, or MAGI, will exempt certain types of income from eligibility calculations. Veterans' benefits, child support, workers compensation and children's income are currently counted as cash income, but they won't be counted under MAGI. The net effect will be to make more people eligible for Medicaid.

The problem for North Carolina is that, to comply, county workers would have to use NC FAST to verify eligibility under the MAGI rules. That would mean re-entering every existing Medicaid client's case information into the trouble-prone new system over the next three weeks. 

Under the implementation schedule, counties were to begin using NC FAST for Medicaid applications last fall. But significant problems with the system have delayed that phase of implementation. 

Acting state Medicaid director Sandy Terrell said requiring county workers to manually enter all existing Medicaid cases - about 1.8 million of them - into the new system by April 1 would create significant workload problems and could jeopardize continuity of benefits for those recipients. 

Many of those same county workers are already struggling to work through food stamp backlogs in NC FAST to meet a March 31 deadline set by the U.S. Department of Agriculture.

Terrell said the state is asking the federal government to allow it to recertify cases under current state rules in its old Medicaid system, EIS, where those case files already exist. That would allow the process to move much more quickly.

If an applicant or current client is found to be ineligible under state rules, which are more stringent than federal guidelines, his or her case would then be entered into NC FAST to check eligibility under the MAGI rules. 

Terrell said the waiver would not cost the state any money and will "ease administrative burdens because [DSS workers] would be able to use the old system they’re most familiar with." 

In the meantime, Terrell said, DHHS will continue to test NC FAST for Medicaid applications in pilot counties.  

The waiver would have to be approved by the Centers for Medicare & Medicaid Services, a process that can take weeks or months. But Terrell said CMS has approved a similar waiver for another state.


This blog post is closed for comments.

Oldest First
View all
  • Marie Clark Mar 13, 2014
    user avatar

    It is not NC Medicaid that is draining the state's budget coffers and preventing all others from receiving... it's the STATE itself by contracting and releasing a seemingly error riddled useless database system.

    The State's inability to streamline and efficiently process both NC Medicaid and Food Stamps... is more of an embarrassment.

    We, the State of NC, cannot even seemingly tie our own shoelaces.

  • mhargrave002 Mar 13, 2014

    I see many comments regarding the ACA and somehow using Medicaid to cause dependency on welfare. According to the American Academy of Pediatrics, 53.5% of Medicaid recipients in NC are children. The rest include the elderly and disabled. Which of these groups do you suppose are the folks who don't deserve medical care?

  • mike275132 Mar 13, 2014

    Article "..Affordable Care Act, all states were required to recertify all Medicaid recipients and applicants .....The net effect will be to make more people eligible for Medicaid."

    So now we know Obamacare /DemocratCare is just another scheme to get more people dependent on Welfare.

  • sabsco Mar 13, 2014

    View quoted thread

    No. But clearly YOU can imagine that.

  • Danny22 Mar 13, 2014

    DennisB, maybe you should take a look at the CBO projections.

  • dennis8 Mar 13, 2014

    View quoted thread

    The problem NC Medicaid has is not related to Obamacare. It is entirely rooted in the highly qualified people McCory appointed to run the DHHS.

  • uBnice Mar 13, 2014

    "What is clear is that the company the Department of Health and Human Services tasked with streamlining the program, Accenture, has a history of complaints. In multiple states across the country, including New York, Texas and Colorado, Accenture has faced serious allegations."

    Taxpayer money is easy money. "Private Industry" simply feeds at the trough.

    Please do not privatize DHHS! We the People have absolutely no reason to trust "private industry"!

  • Danny22 Mar 13, 2014

    Obamacare will bankrupt the whole nation. Not to mention take away our freedoms. Right now Obama is trying to appoint one of his minions who will work to force doctors to monitor gun ownership. Can you imagine that?

  • Wheelman Mar 13, 2014

    Why do we continue to contract with companies that can't seem to deliver a working product? I understand that there will be some issues, but this system seems to be nearly unusable. Are these the same people that developed the Obamacare website?

  • whatelseisnew Mar 12, 2014

    Net effect to make more people eligible which is the last thing that should happen. Medicaid and Medicare should have been eliminated as part of the so called reform. Instead they expanded Medicaid and are stealing from the Medicare people to help pay for the expansion. Federal discrimination is rampant and increasing all the time.