West Virginia has deemed 100K ineligible for Medicaid on procedural grounds

(The Center Square) – Nearly 100,000 individuals have been deemed ineligible for Medicaid based on procedural grounds of the more than 332,000 that have had their eligibility reviewed in the first seven months of West Virginia’s Medicaid redetermination.

The numbers, and the West Virginia Department of Health and Human Resources, do not know if the lack of responses to attempts to determine future eligibility is because the recipient isn’t getting the information, isn’t taking the time to fill out the paperwork or knows they will not be eligible if they do.

The process of the state’s annual required check of eligibility was halted during the COVID-19 emergency. That redetermination pause lasted from March 2020 to March 31 of this year.

Then, the process that is dependent on recipients providing updated contact information and responding to communications from DHHR, began.

The state went from a high of 667,471 enrollees in April to 553,150 in November.

In October, West Virginia had to restore the eligibility of 5,500 children.

The state was one of 30 states that improperly did not automatically renew children separately from families based on eligibility information submitted elsewhere. Children were supposed to have their eligibility auto-renewed based on any information the state has access, including school lunch data.

“They will receive retroactive coverage for just those few missing months to ensure no gap in coverage,” a department spokesperson said. “The county workers received the lists and instructions for processing retroactive coverage by mid-September and immediately began working on restoring coverage for all of the identified children.”

During the first seven months of redetermination, West Virginia has renewed the eligibility of 154,007 of the 332,334 who have come up for review while 38,813 completed the paperwork, were deemed ineligible and were referred to the federal healthcare marketplace, where many were eligible for subsidized health-care plans.