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Governor Barbour on Face-To-Face...

Governor Barbour on Face-To-Face Medicaid Eligibility

By: Magnolia Tribune - February 29, 2008

I take very seriously my administration’s responsibility to provide access to quality health care for people who qualify for our Medicaid program, and in these past four years despite enormous fiscal pressures we’ve made significant progress in preserving Medicaid for the nearly 600,000 Mississippians who rely on it.

To keep Medicaid viable, several reforms have been enacted, and one of the most significant improvements has to do with making sure people who apply for the program are, indeed, eligible. The best way to accomplish this is through face-to-face eligibility determinations. Under my Administration, the Division of Medicaid conducts in-person interviews, which tends to cut down on fraud and abuse but has added advantages, too.

Medicaid spending has been reduced during my Administration, but the federal government is shifting costs to the state by disallowing some of the funds we have used for our state match. The program will need an additional $90.6 million to finish out this fiscal year and an additional $168 million for next fiscal year. Obviously, Medicaid’s future would be impaired if it operated using yesterday’s models and mindsets. I believe our recently enacted yearly face-to-face eligibility strategy is vital in building this program for the better. Here’s why.

In the past, Mississippi Medicaid eligibility determination was conducted in an impersonal manner through the mail. This process actually discouraged applicants from becoming proactive in their own wellness, and the entire process was conducted without the applicant ever being counseled on all the benefits available to them through this multi-faceted program.

Given that the annual determination of eligibility for benefits is a federal law, Medicaid uses this as an opportunity to meet with all of its clients yearly, taking special care to accommodate recipients in nursing homes and others who are not physically able to visit their eligibility worker for this twenty to thirty minute interview. This visit is only a once-a-year requirement. Most demographic information is verified only once, including age, citizenship, and Social Security numbers. Relationships between household members and income need to be verified annually.

The face-to-face meetings that involve coverage of children allow Medicaid staff to assess whether a child appears to be well and healthy, and to explain to the parent any number of available benefits.

For example, parents may be asked to enroll their children in the Mississippi Cool Kids screening program, a free health care program for Mississippi’s children ages birth up to 21 who are eligible for Medicaid. It provides a way for children to get medical exams, checkups, follow-up treatment, and special care they may need to be certain they enjoy the benefits of good health.

When children are eligible, they are referred to a health care provider chosen by the parent; screenings are then scheduled as appropriate. This process has resulted in an increase of more than 20 percent in health care screenings for our kids, up to 85,074 in fiscal year 2007. Back when applications were just mailed in, this enrollment did not occur.

The in-person interview process affords our Medicaid specialists an opportunity to do a thorough and complete evaluation concerning an applicant’s eligibility. Additionally, our own requirement for reviews of these cases by seasoned supervisors means the casework is completed correctly. Most importantly, the in-person interview allows the individual or family the opportunity to personally ask questions and get answers quickly about Medicaid, and to discuss other issues.

Over the past few years, from my Healthy Mississippi initiative to Blue Cross/Blue Shield’s “Let’s Go Walkin’” program, Mississippi has taken many steps toward giving our citizens more access to information on living healthier lives through better medical care, better nutrition, education, physical exercise and getting the full benefit of programs such as Medicaid.

Spending less than 30 minutes once on a face-to-face eligibility check is worth free health care for a year.

Governor Haley Barbour Press Release

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Magnolia Tribune

This article was produced by Magnolia Tribune staff.