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A MEMORIAL

REQUESTING THE HUMAN SERVICES DEPARTMENT TO ANALYZE THE

MEDICAID RENEW PILOT PROJECT, TO PROVIDE DATA REGARDING CASE

CLOSURES AND REINSTATEMENTS, TO REFRAIN FROM CASE CLOSURES

WITHOUT A FINDING OF INELIGIBILITY, TO ADDRESS PROBLEMS

CAUSING MEDICAID-ELIGIBLE INDIVIDUALS AND FAMILIES TO LOSE

COVERAGE AND TO REPORT ITS FINDINGS TO THE LEGISLATURE.

WHEREAS, federal law and regulation require that

medicaid recipients renew their medicaid applications at least

once every twelve months; and

WHEREAS, federal law and regulation prohibit a state

from closing a medicaid case unless the state has made a

finding that the family is no longer eligible; and

WHEREAS, since May 2004, the numbers of women, children

and low-income families enrolled in medicaid have been highly

unstable and have decreased overall; and

WHEREAS, a study by the nonpartisan research company,

Mathematica policy research, incorporated, concluded that

seventy percent of children lose their medicaid coverage every

year; and

WHEREAS, continuity of care is important, especially for

children receiving preventive care and developmental

screenings; and

WHEREAS, in October 2007, the human services department

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instituted a statewide pilot project called the "medicaid

renew pilot project", intended to simplify the renewal process

for both the caseworkers and for women, children and low-

income families; and

WHEREAS, under the medicaid renew pilot project,

children, women and low-income families who are receiving

medicaid and are not receiving benefits from other programs

may now renew their medicaid coverage without submitting a

signed renewal form and instead may renew their medicaid by

telephone, electronic mail, facsimile or regular mail; and

WHEREAS, the human services department has reported an

increase in the number of children enrolled in medicaid since

the implementation of the medicaid renew pilot project; and

WHEREAS, the medicaid renew pilot project remains only a

pilot project and has not been permanently adopted by the

human services department, pending an analysis of the success

of the pilot project;

NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF

REPRESENTATIVES OF THE STATE OF NEW MEXICO that the human

services department be requested to conduct an analysis of the

medicaid renew pilot project that demonstrates how successful

the pilot project has been, including the number of women,

children and low-income family medicaid cases that are due to

renew every month, the number of renewal notices issued every

month, the dates that those renewal notices are issued, the

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number of families that respond every month, the dates that

those families respond, the number of renewal applications

that are processed every month and the number of cases that

are denied or renewed every month; and

BE IT FURTHER RESOLVED that the human services

department be requested to provide data showing how many

women, children and low-income family medicaid cases are

closed every month and when, if ever, they are reinstated; and

BE IT FURTHER RESOLVED that the human services

department be requested to refrain from terminating any

medicaid case unless and until the human services department

has determined one of the following to be true:

A. the participant is no longer financially

eligible;

B. the participant has received notification of

requirements for renewal and has failed to meet those

requirements within thirty days of notification; or

C. the participant can no longer be reached

through any reasonable measures, including telephone, reverse

postal look-up, re-mailing or checking other applicable state

data systems for a more recent address; and

BE IT FURTHER RESOLVED that the human services

department be requested to resolve any problems it uncovers

concerning eligible medicaid recipients experiencing a lapse

or an end to their medicaid coverage; and

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BE IT FURTHER RESOLVED that the human services

department be requested to report to the interim legislative

health and human services committee and the interim welfare

reform oversight committee and to the legislative finance

committee on its findings and any corrective action taken in

July 2008 and again in November 2008; and

BE IT FURTHER RESOLVED that copies of this memorial be

transmitted to the secretary of human services and to the

governor.