Agency wins suit; medical benefits will be reinstated
A legal settlement giving more than 100,000 Pennsylvania families a chance to have their Medicaid medical benefits reinstated highlights one of the biggest and costliest programs in state government.
Community Legal Services of Philadelphia and the state Department of Public Welfare reached the settlement last week to resolve claims that eligible low-income families improperly lost their benefits last year when DPW tackled a backlog of cases due for eligibility reviews and began a crackdown on welfare fraud. Some 90,000 children lost health benefits through the process, according to PA Partnerships for Children and other advocacy groups.
Under the settlement, the families can file for reinstatement for benefits and, if accepted, be reimbursed for medical expenses they incurred when out of the program.
News of this settlement comes with a new analysis of the program released by the House Democratic Appropriations Committee.
Medicaid or medical assistance provides benefits to 2.2 million, or one in six Pennsylvanians. The program costs $22 billion annually, with Washington providing $12 billion, or more than half of that funding.
Children, pregnant women, low-income families, people with disabilities and the elderly all benefit from various Medicaid programs. The fiscal 2012-13 state budget cut Medicaid services to some 35,000 low-income chronically ill adults by tightening eligibility requirements, according to the analysis.
While the political tug-of-war over Medicaid tends to focus on benefits for low-income recipients, they aren't the largest cost drivers for the program.
"The greatest share of Medicaid spending is for the elderly and people with disabilities, reflecting their intensive use of acute and long-term care services," according to the committee analysis. "Although the elderly and people with disabilities represent 38 percent of all recipients, they account for more than two-thirds of Medicaid expenditures. By contrast, low-income families and children represent more than half of all the MA recipients, yet they account for about one-fifth of all Medicaid spending."
The overall numbers break down as $12.6 billion being spent this fiscal year on acute care with payments to managed care organizations and fee-for-service providers such as doctors and hospitals, $7.9 billion for long-term care in payments to nursing facilities, intermediate care facilities and state mental hospitals and roughly $1 billion spread among several smaller accounts, including transportation services to take recipients to health care providers.
The Department of State announced that voters can now file complaints online about alleged election law violations concerning such acts as voter intimidation and unregistered voters casting ballots.
Only registered voters can file complaints. Therefore, the form requires the filer's name, address and date of birth to verify registration status.
The form is available at www.votespa.com and the Department of State website at www.dos.state.pa.us.
(Robert Swift is Harrisburg bureau chief for Times-Shamrock Communications newspapers. Email: firstname.lastname@example.org.)