Saturday, July 01, 2006

Roob Blunder Rains On Daniels' Parade

In what was otherwise turning out to be the best week of Gov. Mitch Daniels' administration, a major blunder by FSSA Secretary Mitch Roob has washed out his week of good news. As a result of a federal class action lawsuit, the agency has admitted it erred in cutting off benefits to 10,000 Medicaid recipients beginning in January of this year. The Star's Tim Evans explains:

The reversal is the result of a federal class-action lawsuit filed last month by six Medicaid recipients who lost benefits -- some without notice or explanation -- because the agency ruled their incomes were too high to qualify for assistance with medical bills.

An agreement reached this week calls for the FSSA to reinstate benefits to the people who have lost services since Jan. 1 and to stop removing other Medicaid recipients from the "spend down" program without a hearing.

The timing of today's news is particularly problemmatic for the administration's controversial effort to privatize intake and eligiblity reviews for FSSA's welfare-related programs. It has been estimated the winning company will be paid at least a billion dollars over the 10-year term of the agreement. The effort came under heavy fire after it was revealed that one of the two major companies vying to win the bid, ACS, is Roob's former employer immediately prior to joining the administration.

So how did so many people get their benefits cut? The agency's spokesman, Dennis Roseborough, told Evans "he could not make any broad statements explaining why individuals lost benefits because so many variables go into individual cases." The man who brought suit thinks he knows what happened. Evans writes:

In some cases where Medicaid assistance was terminated by the state, Severns said it was because of "gross miscalculations" of medical bills. He said benefits were cut off to others even though they filed appeals -- a process that, under federal law, requires the assistance to continue until a determination hearing is conducted.

The problems occurred after the FSSA automated much of the spend-down program in response to a 2003 lawsuit. The new process went online Jan. 1.

Severns said some other problems may be the result of huge caseloads assigned to FSSA workers. Depositions taken in the suit revealed some workers were managing more than 600 cases. He said there also was little or no quality control by supervisors, who should have been reviewing the decisions to cut off benefits.

The problems occurred after the FSSA automated much of the spend-down program in response to a 2003 lawsuit. The new process went online Jan. 1.

The key point here is that an automation system went into effect on January 1. Computer systems can do wonders for helping you get the job done, but they sometimes remove people too much from the process, leading to gigantuan blunders such as occurred here. Severns told Evans that the number of people being removed from the Medicaid program from January to May was six times the normal rate. That should have raised a red flag with someone in the agency that something was amiss, but it apparently took a lawsuit to get Roob's attention.

A mistake of this magnitude has to be laid at the doorstep of the agency's boss, Robb and his senior level managers. This will also likely come into play when the final budget numbers become available. If the state claims to have ended the year with a balanced budget, people will begin asking how much savings in the budget was attributable to recipients being improperly cut off Medicaid benefits? Anyone taking bets on how much longer Roob will remain in his job?

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