Many Philadelphians may lose their TANF and Medical Assistance this Summer

July 15, 2011

Errors by overwhelmed workers anticipated during Logjam July

Philadelphiawelfare offices will have a lot of extra work to do this summer in addition to their other work.  They are being instructed to hold extra interviews for up to 9,300 TANF recipients and review around 16,000 Medical Assistance cases – all by August 12.  We are worried that many families will lose their benefits as welfare workers are overwhelmed by this unwieldy and hasty review process.

For a printable flier on what to expect this summer–including a preview of the notice thousands of families will be receiving–click here.

Who is at risk of losing their benefits?

There are three groups of people who may be at risk:

  1. Adults who have received TANF for more than 60 months in their lifetime since 1997;
  2. Adults who currently have a Good Cause reason not to participate in TANF welfare-to-work requirements; and
  3. Families with pending Medical Assistance renewals. Read the rest of this entry »

Federal audit finds Pennsylvania Medicaid error rate less than half of national rate

December 22, 2010

On November 15, the U.S. Department of Health and Human Services released findings from its audit [pdf] of the Pennsylvania Medical Assistance program.  The audit found that Pennsylvania’s Medical Assistance, or Medicaid, error rate was 4.07%, less than half of the overall national Medicaid error rate of 8.98%.

Ever better news can be found in the details of the report.  Nationally, the error rate for eligibility determinations (i.e., whether the recipient is actually eligible for Medicaid) is 7.60%.  But Pennsylvania’s eligibility determination error rate is a low 1.97%.  That means that less than 2% of Medical Assistance recipients may not have been eligible for the assistance they received.  (The other errors were found in the fee-for-service or managed care programs that had insufficient documentation or provided incorrect diagnosis codes.)

Pennsylvania’s lowest-income families, children, the elderly, and disabled rely on Medical Assistance.  The Department of Public Welfare is to be applauded for administering this critical program so efficiently.

This federal audit contrasts with Auditor General Jack Wagner’s report last year that the Department of Public Welfare had a much higher error rate in the Medical Assistance program.  Why the difference?

Auditor General Wagner’s audit confused administrative errors with intentional fraud.  The Auditor General asserted that the Department of Public Welfare made errors in eligibility determinations for Medical Assistance applicants that countenanced fraud.  In truth, many of the errors had no bearing on applicants’ eligibility: they were eligible for the program but simply didn’t provide (or the Department of Public Welfare couldn’t produce) the requested paperwork.

The Department of Public Welfare should continue to modernize its operations to further reduce its low error rates.  But to do so may require additional budget and staffing. The number of caseworkers in County Assistance Offices, for example, has been reduced dramatically as a result of budget cuts.  There are currently more than 1,600 fewer staff at County Assistance Offices than there were in January 2003 – a 20% reduction.  Meanwhile, the number of households that rely on Medical Assistance has ballooned from 1.8 million individuals in 2006 to more than 2.2 million individuals today – an increase of over 22%.

The Auditor General’s recommendations (for example, that caseworkers verify income twice as frequently) would create an overwhelming administrative burden for caseworkers at a time when they are given insufficient resources to handle staggering caseloads.