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Medicaid Application Backlog Could Cost States

Marilyn Tavenner
Medicare and Medicaid chief Marilyn Tavenner / AP

Some states are experiencing backlogs of Medicaid applications due to technical issues with the HealthCare.gov website and might be punished with decreased federal funding as a result.

The backlogs have forced states to process the applications by hand and Health and Human Services Secretary Kathleen Sebelius suggested reductions in payment if states don’t "pick up the pace."

Republican leaders of House and Senate committees have sent a letter to the Centers for Medicare and Medicaid Services. According to a press release from the Senate Finance Committee:

The congressional leaders write, "Secretary Sebelius’ response seems to suggest that CMS may be in the process of pursuing punitive payment actions against states in spite of – and perhaps even due to – their good-faith efforts to cope with information technology problems resulting from HealthCare.gov. States should not be forced to pay for individuals who are ultimately not eligible for the program. We believe it would be inappropriate for CMS to reduce payments to states that may be experiencing a backlog of applications due to the troubles with HealthCare.gov."

The leaders press CMS Administrator Tavenner: "Is CMS considering or pursuing administrative reductions in payments to states because of state backlogs in reviewing pending applications?" They also request information regarding how CMS would implement those actions and who would be penalized. Finally, they ask: "When will CMS ensure that HealthCare.gov sends states accurate, complete data on applicants who are deemed eligible for Medicaid, in a manner that meets states’ needs?"

Published under: Medicaid