What's New at GWUMC

Children Enrolled in State Children's Health Insurance Programs (SCHIP) are experiencing enrollment delays, disruptions and denials

WASHINGTON — Medicaid documentation requirements enacted by Congress in 2006 continue to present serious, ongoing problems for health centers and their patients, according to a new analysis issued by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at The George Washington University School of Public Health and Health Services (GW/SPHHS). Moreover, changes implemented in the final rule, published in 2007, did little to address these issues, or to alleviate the problems facing eligible health center patients who continue to experience the effects resulting from coverage delays and interruptions to health care. At the same time, the requirements jeopardize health centers' ability to practice in conformance with recognized standards of quality and access due to delays in patient enrollment and payer payments.

This study is the second in a two-part study that looks at the effects of the Medicaid citizenship documentation requirements contained in the Deficit Reduction Act (DRA). The first survey conducted in 2006 found that the DRA requirements adversely affected eligible patients in nine out of 10 health centers. In 2007, health centers served more than 16 million patients at over 6,200 sites nationwide, including more than 5.6 million Medicaid beneficiaries and 5.8 million low-income children. Community health centers are the largest source of comprehensive primary care for low- income patients. Findings in this study include:

-   Three-quarters of all health centers continue to experience significant   problems with citizenship documentation requirements for one or more eligible patient groups.

-  Nearly one-half of health centers continue to report that Medicaid application and enrollment disruptions and delays continue to affect their ability to arrange for specialty care for eligible patients and many affected centers report increased costs associated with helping qualified patients with application and enrollment problems.

-  Documentation requirements appear to have particularly affected access for several specific patient categories, including U.S.-born newborns, whose need for rapid management can become a particularly acute matter.