DCH gets grant to revamp Medicaid enrollment

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The Department of Community Health will use a $2.5 million federal grant to upgrade its systems for enrolling and verifying participants in the Medicaid and PeachCare health insurance programs.

DCH is undergoing the systems upgrade after recent disclosures that the department overpaid by about $105 million the care management organizations (CMOs) that administer Medicaid and PeachCare, which provide health coverage for low-income families and children.

The overpayments were caused by the creation of thousands of duplicate patient records for Medicaid and PeachCare recipients in DCH’s computer system. The duplicate records resulted in CMOs charging DCH and being reimbursed multiple times by the agency for the same patient.

“The work to be accomplished by this grant will help simplify the enrollment and renewal process for eligible children while making the program more efficient and cost-effective,” DCH Commissioner David Cook said.

“By being able to use the latest technology to verify eligibility and improve the application process, we hope to improve access to quality health care for our Medicaid members,” Cook added.

The two-year grant was awarded by the federal Department of Health and Human Services (HHS) and is authorized under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009.

© 2011 by The Georgia Report

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Tags: DCH , enrollment systems , federal grant , Medicaid , PeachCare