State asked 45K to reapply for health coverage

Published 10:37 am Friday, September 30, 2016

By Christopher Snowbeck

Mineapolis Star Tribune

ST. PAUL — The state Department of Human Services has asked about 45,000 people to reapply by the end of September for public health insurance coverage so that officials can fix data mismatches between two computer systems.

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Letters sent in mid-August described a “system problem” that prevented state officials from determining if the enrollees were eligible for benefits in either the MinnesotaCare or Medical Assistance programs.

Those enrollees were given until Sept. 30 to reapply. The state sent disenrollment notices this week to about 40,500 people who hadn’t yet done so.

“People who have not yet reapplied can do so at any time,” the Department of Human Services (DHS) said Thursday in a statement. When coverage might resume for those who haven’t yet done so, however, depends on the program for which they qualify.

Medical Assistance is the name in Minnesota for Medicaid, a state-federal program that provides coverage to many with incomes at or below the poverty line. MinnesotaCare provides coverage to a slightly higher income group sometimes described as the working poor.

DHS determines eligibility for people seeking coverage in the programs via a computer program that used to be called MNsure, which is also the name for Minnesota’s health insurance exchange. DHS renamed its computer system last year as Minnesota Eligibility Technology Systems (METS), which distinguishes it from the MNsure system for people buying private health insurance coverage under the federal health law.

The mismatches involve data in the MNsure/METS system and data in a separate computer system that DHS uses to make payments to managed care companies or health care providers on behalf of enrollees.

The computer systems should automatically sync with one another, but that wasn’t happening in all cases, said Scott Peterson of MN.IT, the state’s division for information technology services. Earlier this year, DHS implemented a fix to the “interface” between the two computer systems that should solve the problem going forward.

In the process, the state learned of the data mismatches, and is now concluding the process of cleaning up those cases.

As of August, about 650,000 people with public health insurance coverage had their cases managed via the MNsure/METS system, so the mismatches involved a minority of those with coverage via the computer system.

Chuck Johnson, a deputy commissioner at DHS, said the data problems for the 45,000 enrollees who were asked to reapply do not constitute eligibility errors.

An audit report in January found that eligibility errors related to the MNsure/METS system were costing the state millions of dollars in early 2015.

“It’s really just a system disconnect between the eligibility record and the payment record that we need to get realigned in order to ensure that we’re managing the program properly,” Johnson said in an interview.

On Thursday, DHS said in a statement: “Those who reapply as of [Friday] and into October and are determined eligible for Medical Assistance will receive coverage effective Oct. 1. Those who reapply and are determined eligible for MinnesotaCare must pay a premium before coverage is effective and would not have coverage until Nov. 1.”