HELENA — Montana leaders have issued a final report, laying out the results of their yearlong review of how many people were eligible to remain on the state’s Medicaid program.
As of June 30, the Montana Department of Public Health and Human Services put together a closeout report with updated numbers from the Medicaid redetermination process. DPHHS leaders discussed the findings at a meeting of the Legislature’s Children, Families, Health and Human Services Interim Committee.
Every state had to check the eligibility of everyone on their Medicaid programs, after the end of the federal COVID public health emergency and an accompanying directive that let people stay enrolled without having their eligibility reconfirmed.
The closeout report shows, out of 280,180 individuals in Montana who went through redetermination, 141,216 – about 51% – were found to still be eligible and had their Medicaid coverage renewed. 115,302 – 41% – had their coverage terminated. For the remaining 8%, DPHHS says it’s still trying to obtain the needed information to make a final determination.
The report says 56% of children in the program maintained their coverage, and 62% of tribal members were renewed.
According to the report, the state’s Medicaid enrollment was several thousand lower at the end of redetermination than DPHHS had projected. The department said, between the “traditional Medicaid” population and those covered under Montana’s Medicaid expansion, enrollment at the time of the report was 222,805 – just under 5,000 below where it was before the start of the public health emergency.
The state is now back to how it operated before COVID: People on Medicaid will have an annual eligibility redetermination, and they will need to report certain changes – like income or household size – to DPHHS in between.
During Wednesday’s meeting, lawmakers also heard from Rose Hughes, executive director of the Montana Health Care Association – which represents nursing homes and other long-term-care facilities. She said some of her members are concerned about lingering backlogs in processing Medicaid applications.
Hughes said she talked to 25 facilities earlier this month, and they reported having 261 residents currently applying for Medicaid or reapplying after losing coverage during the redetermination. She said that means the facilities are providing care for those clients – which she estimated at a total of $8.8 million – but they aren’t yet receiving Medicaid reimbursement payments.
Hughes said facilities told her they’re seeing it take three to six months for their clients to get Medicaid applications approved.
“This in no way is a reflection on the people out in those offices and even out in Helena who are trying to resolve these cases,” she said. “It just seems to be a systemic problem where there’s enough of a backlog and maybe not enough people – or maybe not enough trained people, because these aren’t easy to do.”
DPHHS leaders told lawmakers they’re working to resolve cases as quickly as possible, but the issues are multifaceted, and they believe they go beyond simply staffing. Director Charlie Brereton said the department has been “playing catch-up” because of late paperwork from many Medicaid members and some facilities.
Jessie Counts, administrator of DPHHS’ Human and Community Services Division, said the redetermination process feels new for many members after they didn’t have to go through it during COVID.
“The continuous enrollment period developed a lot of consistency for clients – but a lot of bad habits in what was their responsibility within this process,” she said. “I think as we’ve moved through that, we're going to get much more into a process where we’ve got the shared partnership around eligibility, and it’s much more clear to everyone what’s expected on both sides.”
As DPHHS moves back into its annual eligibility review cycle, leaders told the committee they have about 170,000 cases to process – many of those including multiple individuals.
