defects leave more than 100,000 Americans eligible for Medicaid, CHIP without coverage

When people qualify for those programs, the system is supposed to transfer their application to a computer system in their state and enroll them automatically. Software defects are preventing that from happening…

Interviews with Medicaid officials in most of the 10 states indicate that the effort got off to a rocky start. The idea at first was for CMS to try sending records containing information on about 200 people eligible for Medicaid to each of the 10 states, but the goal was winnowed to 50 records and then to 10, and even fewer in some places. Some of the records sent did not arrive, and some that did contained errors, including people with addresses in other states, according to state Medicaid officials.

In Tennessee, for instance, only three of 10 records arrived the first time CMS tried sending them in mid-December, and the rest disappeared. Shortly before Christmas, CMS attempted to send 10 more and none arrived, according to Tracy Purcell, TennCare’s director of member services. Delaware, meanwhile, received five of the first 10 attempted transfers, according to Stephen Groff, the state’s director of Medicaid and Medical Assistance.

As it became clear by late fall that the automatic-transfer system might not be working in time, federal officials and states began to devise contingency plans. One was to let states use “flat files” that CMS would send, containing rudimentary information about people from the state, some of whom appeared to be eligible for Medicaid.

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