AUSTIN (Nexstar) — A new whistleblower complaint obtained by Nexstar claims technical glitches and disorganized leadership have caused issues in Texas’ administration of Medicaid and erroneously kicked thousands of children and pregnant women off of their health insurance.
“The persistence of numerous and growing system issues remains evident, causing erroneous denials of coverage, particularly impacting newborns and pregnant women—creating a situation that could further agitate our noncompliance with [Centers for Medicare and Medicaid Services] guidelines,” anonymous Texas Health and Human Services employees wrote to Texas HHS Commissioner Cecile Young on Monday.
The complaint describes system coding errors that placed children in incorrect coverage groups, leading to a failure to claim more than $100 million in federal funds. The letter also says over 5,800 pregnant women had their coverage denied and did not receive full postpartum coverage.
“Redetermining Medicaid eligibility for approximately 6 million Texans over 12 months is a massive undertaking, and HHSC has planned this unwinding effort for more than a year. We are working closely with Centers for Medicare & Medicaid Services and our partners to ensure that the redetermination process operates as smoothly as possible,” HHSC Press Officer Tiffany Young said. “We are aware of some Medicaid cases that were denied improperly, and we’ve reinstated coverage for those individuals.”
Source: State employees blow whistle on errors they say are kicking thousands off Medicaid / kxan