Mending the Hole in Medicaid

Screen Shot 2015-11-19 at 2.18.46 PMI was concerned about Alaska’s response to persons seeking to take advantage of the Medicaid expansion and so wrote to the lead on the project. I received a prompt response from Chris Ashenbrenner, and a follow-up e-mail from Sean O’Brien at the Division of Public Assistance (the note from Chris appears second so that the reference to it as “below” by Sean isn’t confusing).
Bottom line?
  • If it you have a medical situation or condition you believe requires immediate attention call 1-844-231-7880.
  • If you have not yet applied for Medicaid expansion, apply for Medicaid online at MyAlaska (under “Services for Individuals” click on “ARIES Self-Service Portal”) or go directly to ARIES at https://aries.alaska.gov/screener/.
  • The federal government has set a 45 day limit for the qualification process.
Yes, there is a backlog. Specifics? They were not forthcoming. Problems? We have a desperate need for competent Social Workers as the welfare safety net becomes too complex to navigate.

The letters:
Good morning Mr. Grober,

I apologize for the delay. To add on to Chris’s information below, there are a number of variables regarding the speed of which applications are processed as she indicated. As she indicated, if there is special expediting needs related to the more immediate health needs of the individual which would be identified in the application, it would be processed more quickly. If not, the federal government has set a 45 day period for us to complete Medicaid eligibility determination. In addition, applications that are submitted electronically, either through the healthcare.gov or our DPA ARIES websites, generally go through faster than paper applications given the increased speed staff are able to process them. Based on what you indicated below, it sounds like one of our Anchorage offices is checking on this particular case. I’m also including our lead on constituent concerns, Jason Burke to check into this as well. I’m cc’ing his supervisor, Aimee Olejasz so she’s informed as well.

I hope this information helps you and your client in this particular case.

Sincerely,

Sean O’Brien, MA, CRC
907-465-5847
Director, Alaska Division of Public Assistance (DPA)
Alaska Department of Health and Social Services
350 Main Street, Suite 304
Juneau, AK 99801

_______________________

Good morning, Mr. Grober.

There is a Medicaid application backlog right now – the applications that are being processed the quickest are those that don’t require any additional information to determine eligibility. However, for a full answer to your questions, I’ve asked the Division of Public Assistance to respond to your questions. One thing you might want to relay to your client is that the Division of Public Assistance has established a process for prioritizing Medicaid applications. Here is the information from their website at http://dhss.alaska.gov/dpa/Pages/default.aspx
Medical Emergencies
Please call 1-844-231-7880, if you submitted an application for Medicaid and someone is experiencing an emergent need for medical assistance such as:
  • Medical procedures to address a life threatening illness or injury
  • Travel for high risk medical procedures
  • Prescriptions that need to be filled
Hope this helps for now – you should hear back for Public Assistance before too long.
Chris
Chris Ashenbrenner
Medicaid Redesign and Expansion Coordinator
Alaska Health and Social Services
Alaska Office Building Room 425
(907) 465-5808 – office
(907) 343-9550 – mobile

2 comments on “Mending the Hole in Medicaid

  1. Marc Grober says:

    An update from the State:

    Dear Mr. Grober,

    Thank you for your inquiry with Chris Ashenbrenner, and for allowing me additional time to respond more specifically to your follow up questions about the Medicaid program, which include; application processing times, the current status of applications in the Expansion Group category, expected turn-around time, if there is a backlog and how it affects turnaround time, the number of applicants day-by-day, and how many have been processed day-by-day. You also commented about the difficulty of obtaining reliable data regarding Medicaid providers, persons applying in the Expansion Group category, and the number of Alaskans found eligible versus ineligible, etc. Ms. Ashenbrenner directed your inquiry to the Division of Public Assistance because most of your questions are from an eligibility standpoint. I am providing some information on covered services administered by the Division of Health Care Services, but would be happy to coordinate answers for any additional coverage questions.

    Your point is well taken that the Department should publish ongoing data for the public regarding Medicaid expansion. We are in the process of developing dashboards that will include this, and additional information so people are able to see the work being done and the benefits to Alaska. We plan to have the dashboards published to the Department’s website by the end of December.

    As Medicaid expansion is less than three months along, we have not yet published any regular data on the Expansion Group category. The Department’s Communications-Public Affair’s Office has provided enrollment numbers to the press, public, and legislators on several occasions. As of this week approximately 5,300 individuals Alaskans are enrolled in Medicaid under expansion. It is too early to report on the numbers of claims paid for these newly enrolled individuals as it often takes providers some time to submit claims to our system, especially the larger clinics and hospitals. In fact, providers have up to one year to submit claims for payment. There are about 18,000 participating health care providers in Alaska who are signed up as Medicaid providers.

    As required under the Affordable Care Act, the State of Alaska began automating its Medicaid application process to include the availability of an online application using its Alaska Resource for Integrated Eligibility System (ARIES). After phase one of this project, there is now continuity between the Federally Facilitated Marketplace (FFM), also known as http://www.healthcare.gov, and ARIES to ensure a seamless application process. There is considerable information about how a person can apply utilizing ARIES and the FFM including a self-help video posted on the front page of DPA’s home page; http://dhss.alaska.gov/dpa/Pages/default.aspx. As of November 1, the FFM began determining Modified Adjusted Gross Income (MAGI) Medicaid eligibility for Alaskan applicants that choose to apply directly through the FFM. This includes those applying for Medicaid under the following categories: Parents/Caretaker Relatives, Pregnant Women, Children under 19, Under 21, Former Foster Care, and the Expansion Group. If an individual is determined to be ineligible for Medicaid through the FFM, the applicant is then screened for eligibility of subsidies for healthcare subsidies to reduce their monthly premium costs as well as for cost sharing reductions (co-pays, deductibles and co-insurance). The State of Alaska does not have data available regarding the number of people who were determined ineligible for Medicaid benefits under the Expansion Group category.

    The Division of Public Assistance is determining eligibility for incoming Medicaid applications and at the same time endeavoring to reduce the backlog of older Medicaid applications. It is not possible to provide a day-by-day count regarding the number of applications received as data sets are obtained from multiple sources. Currently the Division of Public Assistance is only able to provide weekly data on applications processed through ARIES, and more comprehensive monthly data when it polls its older Eligibility Information System.

    The Division of Public Assistance continuously reviews processes and procedures in an effort to improve its ability to serve Alaskans in need by providing timely eligibility determinations for the Medicaid program, including the new Expansion Group category. Feedback from members of the public is a crucial part of system improvement. There are multiple avenues through which we offer assistance: over the phone, online, or through the mail (with or without participation from an assisting agency). Our goal is to maximize efficiency and responsiveness through these modes and provide reasonable accommodations when requested. This includes prioritizing an application if there is an emergent need.

    Thanks again for your questions. We look forward to sharing more information once the dashboards become available. Happy Thanksgiving!

  2. […] to the Medicaid Expansion Coordinator and the DPA Director, Sean O’Brien as a follow up to my prior investigation. It has only been a couple of days, but I suppose I really am not expecting much of anything with […]

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