RI aims to kick 20,000 off Medicaid by August

PROVIDENCE, R.I. (WPRI) – Officials have set an aggressive goal of removing 20,000 ineligible individuals from Rhode Island’s Medicaid rolls over the next four months as they try to address problems caused by the state’s troubled new computer system for benefits.

In testimony before the twice-a-year Caseload Estimating Conference, which advises lawmakers on the state budget, R.I. Executive Office of Health and Human Services said they want to terminate 2,300 ineligible Medicaid recipients in May. After that: 5,100 in June, 9,600 in July, and 3,000 in August, with another 1,500 slated for the fall.

Patrick Tigue, the state’s new Medicaid director, said the numbers represent the agency’s best estimate of how many ineligible people are currently on Medicaid, most because their incomes have risen beyond the program’s maximum. The new Unified Health Infrastructure Project (UHIP) computer system has been unable to track such changes accurately until recently, and the extra cost to taxpayers is running at roughly $1 million a month, he said.

“Our approach is to move as aggressively as we can but not any faster than that,” Tigue told Eyewitness News.

“What I mean by that is that we know we have an obligation both to Rhode Island taxpayers but also to the individuals who are enrolled in Medicaid to ensure that people who are on Medicaid, who deserve to be and who qualify, remain so, but also those that aren’t, are no longer,” he said.

Tigue said the first step will be sending letters to thousands of Medicaid enrollees who may or may not still be eligible for the program, seeking additional documentation on their incomes. He said enrollees will have 10 days to respond to those letters, and urged beneficiaries to make sure their addresses are up to date.

Tigue also said the state will not seek to get back money from individuals who received Medicaid benefits after they became ineligible.

The state’s timeline drew concern from Linda Katz, policy director of the Economic Progress Institute, which advocates for low-income Rhode Islanders.

“It probably is too aggressive to think about removing that many people who are ineligible based on income,” Katz said, saying state officials should ensure those losing Medicaid coverage receive help signing up for insurance through HealthSource RI.

Katz emphasized, however, that she is “confident” Tigue is “really committed to making sure that people who are eligible remain eligible and that people who need help transitioning into a qualified health plan are able to do that.”

One of state officials’ selling points for the $364-million UHIP system was that it would quickly pay for itself by more aggressively removing ineligible individuals from social services. But in their Caseload Estimating Conference testimony, Health and Human Services leaders now suggest those savings were oversold.

The “original estimate likely overstated the potential impact and savings associated with Enhanced Post Eligibility Verification,” they acknowledged, using the formal term for the process.

Susan Campbell (scampbell@wpri.com) is the Call 12 for Action and Target 12 consumer investigator for WPRI 12 and Fox Providence. Follow her on Twitter and on Facebook.

Ted Nesi (tnesi@wpri.com) covers politics and the economy for WPRI.com. He writes Nesi’s Notes on Saturdays and hosts Executive Suite. Follow him on Twitter and Facebook