SENATE JOINT MEMORIAL 21

47th legislature - STATE OF NEW MEXICO - second session, 2006

INTRODUCED BY

Dede Feldman

FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE

A JOINT MEMORIAL

REQUESTING THE HUMAN SERVICES DEPARTMENT TO DISCONTINUE THE PRACTICE OF AUTOCLOSURE IN THE MEDICAID PROGRAM.

     WHEREAS, the number of medicaid enrollees is routinely reduced by the automatic disenrollment of participants, a practice known as autoclosure; and

     WHEREAS, this practice affects predominantly children and pregnant women; and

     WHEREAS, autoclosure occurs when a period of certification of medicaid eligibility expires and the information to reenroll the participant has not taken place, thereby activating a computer process that automatically disenrolls the participant; and

     WHEREAS, there are many legitimate reasons why the reenrollment process does not occur on a timely basis, including caseworkers' inability to complete the paperwork due to overly heavy caseloads, participant or caseworker illness, lost reenrollment application information and lack of understanding of the requirements for reenrollment; and

     WHEREAS, in the past, closure of a medicaid case required an active step of entering information into the computer, but closure is now accomplished automatically, without human involvement; and

     WHEREAS, thousands of women and children are disenrolled from medicaid every month, and in the last year approximately twenty thousand women and children lost medicaid coverage due to this practice; and

     WHEREAS, health care providers report that it is difficult to reenroll these women and children by using the process of presumptive eligibility due to burdensome paperwork requirements and the large volume of people affected; and

     WHEREAS, parents and children who lack medicaid coverage may not seek appropriate medical intervention on a timely basis, due to a fear of not being able to afford the care, and then require more costly and serious care at a later time; and

     WHEREAS, up to eighty percent of the people whose cases are automatically closed are found to be eligible for medicaid and are reenrolled within six months; and

     WHEREAS, very few people who are medicaid eligible actually experience a change in economic condition that would result in legitimate disenrollment from the medicaid program;

     NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO that the human services department be requested to discontinue the practice of autoclosure in the medicaid program; and

     BE IT FURTHER RESOLVED that copies of this memorial be sent to the secretary of human services and the governor.

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