RCPA - Rehabilitation and Community Providers Association


DPW Agreement on MA Disenrollment
October 24, 2012

Over the past year PCPA has reported on the very high number of children and adults who were being dropped from Medicaid (MA) roles and growing questions about this process and the impact on services. The Department of Public Welfare (DPW) has not offered answers on why cases became so backlogged or why so many people were struck from Medicaid rolls.

On October 24 the Philadelphia Inquirer reported that as a result of action by the Community Legal Services in Philadelphia and action by the Obama administration, many of those inappropriately dropped may be reinstated. Last year, DPW identified about 385,000 households that were overdue for redetermination about whether recipients were still eligible for Medicaid. Between August 2011 and January 2012, about 130,000 people – including 89,000 children – were dropped from Medicaid rolls. The agreement stipulates that a new letter on distinctive blue paper will be sent to about 100,000 Pennsylvanians previously found ineligible for Medicaid informing them of their right to appeal. The Philadelphia Inquirer reports that as a result of an agreement between DPW and the legal team handling the challenge:

  • Letters will be sent to residents who lost benefits between July 1, 2011 – January 31, 2012, giving individuals and families 30 days to fill out and return an appeal form;
  • A special unit will work solely on processing the re-applications;
  • DPW will try to use online databases to check household incomes to help determine Medicaid eligibility; and
  • Some MA recipients that had been removed from the rolls could have their medical bills resolved if they were billed or paid for coverage while they were off Medicaid.

"We thought a lot of people were losing eligibility because they allegedly had not sent in the correct documentation," said Richard Weishaupt, a senior attorney with Community Legal Services. "We thought that was unusual, since most of these people had figured out how to get on and had submitted documentation." DPW spokesperson Carey Miller stated "We will send out letters to those specific individuals telling them they can appeal anytime through DPW."

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