News Center

Mississippi Now Alone in Face-to-Face Recertification News

Posted Friday, April 03, 2009

Mississippi Now Alone in Face-to-Face Recertification

New Report Finds that Face-to-Face Does Not Reduce Fraud

The State of New York’s decision to eliminate face-to-face recertification for all Medicaid/CHIP beneficiaries leaves Mississippi even further behind in health care. With this decision, Mississippi is now the only state that requires in person recertification (face-to-face) for families seeking Medicaid/CHIP benefits for their children.

In crafting a state budget, New York lawmakers found face-to-face to be a burdensome and costly administrative rule the state could no longer afford in an economic downturn. That state’s governor said that eliminating face-to-face would, “help enable eligible children and adults to secure and keep (health) coverage.”

“Mississippi is continuing a course directly opposite to that of every state in the nation,” said Roy Mitchell, Program Director of the Mississippi Health Advocacy Program. “While other states are exploring paths to better, affordable healthcare for more of its citizens, Mississippi is continuing to erect barriers to healthcare.”

Face-to-face has proven to be costly in terms of implementation, impact on the state’s health rankings, and long-term care costs and outcomes. Also, Governor Barbour’s claims that face-to-face is a fraud deterrent have been proven false. A March 25th report issued by the Center on Budget and Policy Priorities found that the governor’s press release touting that face-to-face has resulted in a lower level of fraud than the national average is “fraught with errors and is misleading in numerous ways.”

A fact check of Governor Barbour’s March 5 press release found a number of inaccuracies.  One inaccuracy cited in the report is the “error rate” the governor used to support his claim.  “Error rate” is not a measure of fraud but an indicator of how often states make mistakes in eligibility decisions and in paying medical claims.  The Payment Error Rate Measurement (PERM) the governor used is intended to measure the number of eligible persons denied coverage or the number of ineligible person allowed coverage. It is not a measurement of fraud.

The Governor has since removed the press release from his website and the spokesperson for Mississippi’s Division of Medicaid admitted to that “there’s no way to prove (face-to-face) has reduced fraud.”

Supporters of Mississippi’s face-to-face interview requirement have used flawed data in a misleading way to prop up a policy that, in better economic times, was a clear failure.  Now, as a growing number of families struggle with unemployment and economic hardship, Mississippi has continued to impose this unconscionable barrier on uninsured families seeking health coverage.  Instead of wasting time and resources on rooting out illusory fraud, the state should focus on helping low-income families by simplifying eligibility procedures for Medicaid and CHIP. – Center on Budget and Policy Priorities.

The Division of Medicaid has testified that it has added 409 workers to operate its “face-to-face” process, nearly doubling the previous size of the program, while the cost of this massive increase was itemized at $48.5 million. Over the same period, 60,000 eligible children have been cut from the Medicaid/SCHIP roles as a result of the policy.

Both the Mississippi Senate and House recognized the need to end this policy and passed HB 105, a Medicaid technical amendments bill with language ending the face-to-face recertification for children 16 and under. The bill died in conference on April 1st but lawmakers will reconsider the issue when they return to the Capitol in May or June.

Click here to view the report.