HOUSE MEMORIAL 125

49th legislature - STATE OF NEW MEXICO - first session, 2009

INTRODUCED BY

Mimi Stewart

A MEMORIAL

RELATING TO PUBLIC ASSISTANCE; REQUESTING THE HUMAN SERVICES DEPARTMENT TO MAKE MONTHLY REPORTS AND TO RETAIN DOCUMENTATION REGARDING MEDICAID AND THE STATE CHILDREN'S HEALTH INSURANCE PROGRAM ENROLLMENT AND RETENTION.

     WHEREAS, the medicaid and state children's health insurance programs provide health coverage to over four hundred thirty thousand New Mexicans, or approximately one out of every five residents; and

     WHEREAS, enrollment in medicaid has been very unstable for children, women and families over the past five years; and

     WHEREAS, almost one-third of New Mexico children who are eligible for medicaid and the state children's health insurance program are not enrolled; and

     WHEREAS, health care providers and advocates for the poor report that individuals have had their cases denied or terminated by administrative procedures that prevent eligible people from receiving benefits to which they are entitled; and

     WHEREAS, collecting data on enrollment and retention is essential for evaluating the medicaid program, maximizing enrollment and enhancing administrative efficiency; and

     WHEREAS, well-run programs around the country routinely collect data on case denial and closure rates, point-in-time enrollment and budgets listed by type of enrollee; and

     WHEREAS, the human services department collects and stores information on the reasons why medicaid applications are denied and cases are closed, but does not publicly report these reasons; and

     WHEREAS, the human services department provides denial rates and closure rates for other public assistance programs in a monthly statistical report, including these rates for the supplemental nutritional assistance program formerly known as the food stamp program, temporary assisstance for needy families and general assistance programs, but not for the medicaid program; and

     WHEREAS, all states must report data under new federal requirements on the enrollment of children in medicaid and the state children's health insurance program, including data on eligibility criteria, enrollment and retention, and denials and redeterminations of eligibility;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the human services department be requested to make available on an internet web site that the department maintains, and through publication of a monthly statistical report, data to assess the enrollment and retention of individuals who are eligible for medicaid and the state children's health insurance program, including annual budget projections and expenditures by category of eligibility, monthly point-in-time numbers of enrolled recipients, listed by each category of eligibility, showing the number of individuals actually enrolled in medicaid or the state children's health insurance program at the time of reporting; and

     BE IT FURTHER RESOLVED that the human services department include in the report monthly denial rates for medicaid and the state children's health insurance program, including for each month the number of applications that the department received; the number of applications that the department approved; the number of applications that the department denied; and for those applications denied, the number of cases denied and the denial code, listing according to income or asset ineligibility; voluntary withdrawal; procedural denial; categorical ineligibility; or any other reason for denial or ineligibility; and

     BE IT FURTHER RESOLVED that the human services department be requested to report monthly the termination rates for medicaid and state children's health insurance program cases, including the number of cases due for renewal, the number of renewals received, the number of renewals denied, the number of recipients whose cases were terminated, along with the reason for termination by code, and the number of recipients that the department disenrolled and reinstated within six months; and

     BE IT FURTHER RESOLVED that the human services department be requested to report to the interim legislative health and human services committee and provide that committee with the data set forth in this memorial by November 1, 2009 and again by November 1, 2010, as well as provide that committee with a report concerning its progress on providing the public with this data; and 

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the governor, the secretary of human services and the chair and vice chair of the legislative health and human services committee.

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