HOUSE MEMORIAL 4

48th legislature - STATE OF NEW MEXICO - first session, 2007

INTRODUCED BY

Danice Picraux

A MEMORIAL

CALLING ON THE HUMAN SERVICES DEPARTMENT TO IMPLEMENT QUALITY-CONTROL PROCEDURES IN ITS MEDICAID RECERTIFICATION PROCESS BEFORE CLOSING A MEDICAID FILE AND TO AUDIT ITS NEW AUTOMATIC-CLOSURE PROCESS.

     WHEREAS, an estimated twenty-one thousand children have lost medicaid health coverage over the past two years; and

     WHEREAS, the number of persons on medicaid in New Mexico is the lowest it has been since 2002; and

     WHEREAS, the human services department implemented a new program to close medicaid cases automatically without review if clients have not properly recertified; and

     WHEREAS, over one hundred twenty thousand medicaid cases have been automatically closed since the new policy was put in place; and

     WHEREAS, an estimated seventy-five percent of the closed cases were reinstated; and

     WHEREAS, thus far, there has been no adequate explanation of why such a high percentage of cases that were automatically closed were reinstated; and

     WHEREAS, when a medicaid file is automatically closed, children as well as parents lose medicaid benefits; and

     WHEREAS, children cannot ensure that their parents properly recertify or reapply for them; and

     WHEREAS, between the automatic closure of a medicaid case and its reinstatement, a child's health care is disrupted; and

     WHEREAS, such disruption of the doctor-child relationship may cause interruption in vaccination regimens; and

     WHEREAS, there is no process in place for auditing whether cases are appropriately closed;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the human services department be encouraged to track the numbers of cases terminated on a monthly basis and to institute an audit process in order to determine the percentage of terminated cases and whether those cases are later reinstated; and

     BE IT FURTHER RESOLVED that the human services department be encouraged to track a representative sample of cases assigned for automatic termination, reviewing such sample cases before actually terminating clients; and

     BE IT FURTHER RESOLVED that the human services department be encouraged to weigh whether a case in the representative sample was accurately assigned for termination, whether the case involved a child who should not be penalized for a parent's failure to recertify and whether the disruption caused by a wrongful termination was justified by the administrative-cost savings of an automatic closure; and

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

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