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i_comedicaidcl_2016a_2016-06-24t08:35:09z3 Hearing Summary

Date: 06/24/2016


Client Perspectives on Medicaid Letters and Suggestions for Improvements


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10:45 AM -- Client Perspectives on Medicaid Letters and Suggestions for Improvements

Julie Reiskin, Executive Director, Colorado-Cross Disability Coalition, thanked the committee for the brining the issue and distributed a handout to the committee (Attachment D). She noted that readability of notices is only one component of the challenges with Medicaid communication. She explained that clients are having issues receiving notices in a timely manner and receiving open enrollment letters every year. She responded to a question regarding communication with clients with disabilities.

160424 AttachD.pdf160424 AttachD.pdf

10:51 AM

Ms. Reiskin went over the different types of communication with Medicaid clients, including notices, calls, and emails. She suggested that a greater effort should be made to move away from blaming clients in notices. She noted that programs other than traditional Medicaid are problematic because they do not receive much attention. She described the issues with forms of communication other than the notices, including problems contacting HCPF by phone. She summarized other issues with communication, including state and county confusion, missing information, not following up with clients in a timely manner.

11:00 AM

Ms. Reiskin described client issues with written Medicaid notices, including contradictions, incorrect regulations, and unclear information on appeals.

11:03 AM

Elisabeth Arenales, Colorado Center on Law and Policy (CCLP), explained the role of the center and their work with Medicaid clients. She distributed handouts to the committee (Attachment E) and gave an overview of the Colorado Benefits Management System, and the evolution of the system. She noted that there have been multiple efforts to improve client communications, including using stakeholder meetings and focus groups. She summarized problems with communication that have not been addressed, including missing notices, incorrect dates, and conflicting information. She noted that many of these problems are incorrectly blamed on user error. Ms. Arenales continued the discussion by explaining that staff training is not sufficient to address the problems with the system.

160424 AttachE.pdf160424 AttachE.pdf

11:15 AM

Ms. Arenales responded to a question regarding the origin of the communication problems. She noted that the Medicaid communication has improved, but she is unsure whether the issues are a result of poor training or programming issues. Ms. Reiskin provided examples of programming issues, and confusion between the state and county agencies. Ms. Arenales noted that the county involvement in the Medicaid system is challenging, but it would be difficult to combine it with the state.

11:24 AM

Bethany Pray, CCLP, provided an overview on the legal requirements for Medicaid notices and denials. Her presentation was handed out to the committee (Attachment F). She described the due process requirements for notices. She explained that notices must be in plain language, timely, and provide adequate information, including a reason for the action. Ms. Pray explained that the information in the notice may be too vague and general for a client to understand. She explained that clients must follow-up to obtain necessary information from HCPF, and this may lead to loss of benefits.

160424 AttachF.pdf160424 AttachF.pdf

11:32 AM

Ms. Reiskin discussed the concerns that the disability community has with Medicaid correspondence. She explained that the disability community relies heavily on the Medicaid system, and the issues with Medicaid communication may make their lives difficult. She provided examples of specific problems that have occurred as a result of incorrect or confusing Medicaid correspondence.

11:39 AM

Ms. Arenales provided a handout to committee and (Attachment G) and discussed the CCLP's four preliminary recommendations for improvements to Medicaid correspondence with clients. Ms. Arenales responded to a question regarding the type of audits on client notices. She noted examples of best practices in other states. Ms. Reiskin made final comments on the tone of Medicaid notices.

160424 AttachG.pdf160424 AttachG.pdf

11:47 AM

Representative Primavera adjourned the meeting.