Just as congress is trying to pass legislation which will give Medicaid a boost, Alaska has been put on a moratorium by the federal government and CMS due to noncompliance when it comes to enforcing Medicaid rules. This is temporary, however there is no guess as to how temporary it will be.
Because of this moratorium, many people who need to sign up for Medicaid need to wait until this is over. The review raised concerns that the state Medicaid agency has not taken necessary safeguards "to protect the health and welfare of the recipients of the services."
Until the review is done, there can be no more individuals added to the Medicaid rolls. The review has been called for because of several areas of non-compliance. For instance, form 27 to 2009 the state reported 27 Alaskans died while waiting for initial assessments and 227 died while waiting to be reassessed.
The system should work much faster than that. The state says that it was behind in assessments because it did not have enough nurses. The review also found the state is not in compliance with requirements for all waivers.
"CMS has determined, in order for us to develop our business processes and refine those that we have in place, that a moratorium is necessary," Rebecca Hilgendorf, director of Senior and Disabilities Services said.
Theresa Bovey, CEO of Trinion Quality Care Services, which provides in-home personal care in Anchorage, says this moratorium could have a huge impact on those who need Medicaid and won't be able to get it now.
It is hopeful that these issues can be resolved quickly and enrollment can begin again after the moratorium is lifted, however, the review is not scheduled until March. In the meantime, the state must create a plan that shows what they will do to improve their Medicaid services. This plan must be presented to CMS before they will consider ending the moratorium.
It has been about two years since the Deficit Reduction Act went into effect (7/1/06) requiring all immigrants to give proof of legal immigration or citizenship when they are applying for Medicaid for the first time. This applies to children, as well. Most legal immigrants cannot receive Medicaid benefits for the first five years that they are in the U.S. and undocumented immigrants can only receive emergency Medicaid services.
Once the bill became law, it also restricted citizens, as well. Medicaid enrollment has declined since the law was enacted, partially because even U.S. citizens are finding it difficult to locate some of the documents required to enroll for Medicaid services. This is because some of the documents need to be original documents, and it can be difficult to obtain original documents in many cases.
As far as Medicaid goes, they receive matching federal funds to help run the program and pay claims. As a result, even if they wanted to assist individuals without documentation it would be a problem for Medicaid both in a financial sense and in a legal sense.
The rules are so stringent that CMS has instituted a rule that even requires child welfare agencies to document citizenship for children being placed into foster care. There are some issues where people receive extra time to provide documentation, however, they are limited and must adhere to very specific rules and time frames.
Once an individual has completed the documentation process and is approved for coverage, they will be covered retroactively to the date of the application or to the month of the application depending on the state they are living in and a few other variables.
The primary types of identification include a state driver’s license, Certificate of Naturalization, Certificate of Citizenship or a U.S. passport. Secondary types of identification for naturalized citizens include a U.S. Birth Certificate, data verification with Systematic Alien Verification for Entitlements (SAVE) documentation, or documentation and data match with a state verification agency, as well as other documents.
It is important to know the law, your rights, your responsibilities and your entitlements in order to receive the benefits you need. You can research them on the web by going to the CMS website.
