More than 150,000 people have been scratched off Pennsylvania’s medical assistance rolls in the last five months amid a crackdown aimed at Medicaid waste that health care advocates believe has also wrongly removed needy and disabled residents from the list, a newspaper reported Thursday.

The Philadelphia Inquirer reported 90,000 cases were cut in November alone while the Department of Public Welfare aggressively stepped up eligibility reviews. A total of 43,000 children have been taken off state medical assistance since August, the newspaper reported.

Most of those cut from medical assistance are dead, moved out of state or are otherwise ineligible, state officials said. But the Department of Public Welfare was unable to provide The Inquirer with a breakdown of how many of the purged cases were in each category.

The huge cuts are notable because they come as most states are seeing Medicaid enrollment rise or at least stay flat. That’s raising red flags for health policy advocates worried that Pennsylvania is purging deserving cases as it tries to save $200 million by eliminating waste, fraud and abuse under the budget approved in June.

Advocacy groups told The Inquirer they’ve received hundreds of reports of people wrongfully taken off the rolls. But state officials insist they’re sticking to proper review procedures, giving clients 15 days to respond to the state’s inquiry and another 15 days’ notice before their benefits are canceled.

“We conduct re-determinations with sensitivity … and accommodate as much as we can to the clients’ needs,” Lourdes Padilla, the department’s acting deputy secretary, said. “Nothing has changed.”

The union representing case workers said reviewers were ordered to aggressively close cases for technical reasons when the state ordered them to examine hundreds of thousands of backlogged cases. Padilla denied case workers were pressured to close cases.

One Philadelphia woman reported she got a letter Sept. 15 saying her coverage would be cut off in four days unless she sent renewal paperwork. They were cut off anyway.

Marie Stopa told the newspaper her 10-year-old son needed two trips to the emergency room to deal with asthma attacks she said would have been avoided with medication she could no longer afford.

Advocacy group Public Citizens for Children and Youth said it’s working with Stopa to get her benefits reinstated, which would retroactively cover the $2,100 in emergency room bills that need to be paid.

Health care advocates worry that it could be some time before the full scope is known of cases wrongly cut from assistance.

“If people don’t have an immediate medical need, they may not know that they have lost their coverage,” said Ann Bacharach, an eligibility specialist for the Pennsylvania Health Law Project.

The Philadelphia Inquirer – December 15, 2011 – اقرأ المقال على الإنترنت