Documenting Medicaid Terminations

Please see this request from Community Legal Services for assistance in documenting Medicaid terminations of people who may eligible for continued benefits but for various reasons were not able to comply with documenting their continued eligibility.

Please share this information with others. As of October 20, 2011 there had been a net closure of 105,000 Medicaid cases. OMHSAS cites the overwhelming majority of the terminations are legitimate however advocates continue to hear from eligible people who had their benefits terminated.

What to Do if You or Your Family Member Believes Benefits Were Wrongly Terminated

• File an appeal to the advance termination notice within 13 days on the postmarked date (make a copy to keep)
• Mail the appeal via certified mail and request a return receipt or hand deliver the appeal to the CAO and ask for a receipt
• Contact the OMHSAS western operations field office in Pittsburgh at 412-565-5226
• Contact your respective state legislators to inform them of your situation
• Please contact the NAMI Southwestern PA office 1-888-264-7972 as we are attempting to track the number of people living with mental illness that are affected

People needing assistance with filing appeals or who have other questions related to benefits can contact the PA Health Law Project Helpline at 1-888-274-3258.


From Community Legal Services:

Community Legal Services is seeking your assistance. As you may know, over the past few months, the Department of Public Welfare has issued policies that have called for a series of reevaluations of eligibility that have resulted in the closing of at least 100,000 Medicaid cases. Many of these individuals are still eligible for Medicaid and were not given adequate opportunity to demonstrate their continued eligibility. Children, disabled, and elderly communities have been particularly affected. Community Legal Services is reaching out to you to assist us in documenting the case closures that have resulted from these recent policies. We are looking for Medicaid closure cases with the following characteristics:

• Their case closed sometime between July 2011 and the present
• Their case closed for noncompliance with the redetermination process (meaning that they allegedly did not return their redetermination/re-evaluation packet)

If you know of individuals who fit the above description, please ask them to fill out the questionnaire or fill it out on their behalf: bit.ly/vqC1Wk (Contact NAMI Southwestern Pennsylvania at 1-888-264-7972 for access to paper questionnaires.)

All information will be kept confidential and we will not make public any identifying information without express permission. If you are unable to provide us with a client/patient name, please provide as much other information as possible. We are trying to move forward quickly so please feel free to fill out the questionnaire now without a client/patient name and then we can work together to obtain a release form in the future. Instructions on how to return the questionnaire are included in the attached document.

Please forward this to anyone you think would be interested in filling out this questionnaire. We would also appreciate any suggestions as to additional organizations or individuals who could help us identify individuals affected by these recent Medicaid terminations.