Medicaid eligibility reviewed in hearing

A federal official initially denied Arkansas' request for records related to a Medicaid application that a Brickeys woman said she submitted more than 10 months ago, a state Department of Human Services official testified Monday.

Dave Mills, a Department of Human Services program administrator, testified in U.S. District Court in Little Rock that he asked an official with the Centers for Medicare and Medicaid Services on Oct. 9 for records related to Anita Walker's Medicaid application and was told the records would not be released without a subpoena.

Mills said he asked again during a conference call Monday and was told the federal officials would "need to look into these circumstances."

Mills testified during a hearing on a request by Walker that Judge Kristine Baker order the Human Services Department to make a determination on her Medicaid eligibility "as soon as possible."

In a lawsuit filed Oct. 9, Walker, 53, said she's been waiting for word on her eligibility since Nov. 24, 2014, when she applied through the federal healthcare.gov website.

Federal rules require the state's Medicaid program to determine eligibility within 45 days of an application being made.

Human Services Department officials testified that they never received any records on Walker's application from the federal Centers for Medicare and Medicaid Services, which runs the enrollment website.

The state officials said Walker could file an appeal through the federal agency, with a request that the appeal be handled by the state Department of Human Services. The federal agency would then forward records on Walker's application to the state, the officials said.

Susan Burton, the business process manager for the state's Medicaid enrollment system, said Walker could also apply directly through a state website, access.arkansas.gov. If she were found eligible, the state would "work with her" to retroactively cover her medical expenses back to Nov. 24, Burton said.

Kevin De Liban, an attorney with Jonesboro-based Legal Aid of Arkansas who filed the suit on behalf of Walker, said Human Services Department officials didn't tell him before Monday that Walker could apply through the state website and receive such retroactive coverage.

Instead, after a hearing on Walker's request for a determination on her eligibility, an administrative review officer with the department wrote on Aug. 6 that she couldn't rule on Walker's request because Walker hadn't appealed through the Centers for Medicare and Medicaid Services.

De Liban said it's the Human Services Department's responsibility to ensure that applications are processed within the required time frame.

Applicants shouldn't have to jump through additional hoops to get a determination on their eligibility, he said.

Arkansas has encountered widespread problems receiving information on applications submitted through the federal website, Human Services Department officials have said.

At the same time, a lack of functionality in the Medicaid program's computerized enrollment system has led to a backlog of applications.

Baker said she would study the issue this week and issue a ruling soon.

Metro on 10/20/2015

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