- Associated Press - Tuesday, May 12, 2015

COLUMBUS, Ohio (AP) - About 154,000 Ohio residents will have their Medicaid health benefits restored and their eligibility for the program rechecked as part of a settlement reached in a lawsuit against the state, the state’s Department of Medicaid said Tuesday.

The agreement comes in a case involving how Ohio officials “re-determine” the eligibility of recipients in the federal-state health program for the poor and disabled.

In March, the Legal Aid Society of Columbus sued the state’s Medicaid director on behalf of several people and two nonprofits in central Ohio: the Community Refugee and Immigration Services and Community Development for All People. They claimed that some individuals’ Medicaid benefits were terminated or put at risk after Ohio failed to follow federal law and Medicaid regulations during the review process.

Among other issues, the legal group had argued that Ohio failed to conduct certain Medicaid renewal procedures and did not adequately notify recipients as to why coverage was being terminated and how to appeal.

Federal law requires states to “re-determine” annually whether recipients remain eligible for Medicaid. Beneficiaries have their eligibility reviewed the same month they enrolled the previous year.

State figures show that 153,743 beneficiaries lost Medicaid coverage during the first three months of the year because they failed to respond to Medicaid renewal packets.

The settlement agreement restores the health benefits of those terminated from the program in January, February and March. Individuals will be informed no later than June 1 that their coverage is being reinstated. They can then use the letter as proof of their Medicaid eligibility to health care providers. Ohio Medicaid will have until Aug. 1 to put them back on the program, and beneficiaries will then have their eligibility checked again.

The agreement does not apply to certain residents who submitted renewal information to the state and were found ineligible for the program.

A spokesman for the Ohio Department of Medicaid said the settlement allows Ohio to continue the monthly eligibility checks as required by federal law.

“We’re happy to have been able to work through these issues in an expedient manner and reach an agreement with the plaintiffs,” Ohio Medicaid spokesman Sam Rossi said.

The settlement makes other changes to Ohio’s process, including creating a centralized statewide telephone number for renewals and including prepaid return envelopes in renewal packets. It directs Ohio Medicaid to make a good-faith effort to promote online and phone options for renewing Medicaid. The state also must provide renewal documents in Spanish and Somali. Officials must include information on the availability of interpreter services in 91 languages.

Kathleen McGarvey, deputy director of Legal Aid, said the agreement will result in hundreds of thousands of individuals “maintaining the coverage they are eligible to receive under the law and being able to seek the medical care they need, without worrying about racking up medical bills or having to forgo other necessities.”

Last month, U.S. District Judge Algenon Marbley ordered Ohio to reinstate benefits for individuals in the case along with those members identified by the plaintiff organizations as dropped from Medicaid or at risk of losing benefits based on the state’s procedures. The judge also temporarily blocked the state from terminating the coverage of members belonging to the two organizations unless officials adopted certain practices such as using more detailed termination notices and instituting a “passive” re-determination process in accordance with federal law.

Ohio started the “passive” process in April, whereby officials use existing information from databases and other sources to verify income, household composition and other Medicaid eligibility criteria.

Medicaid provides health coverage to nearly one out of every four Ohioans.

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