{"id":805,"date":"2022-07-19T16:23:28","date_gmt":"2022-07-19T16:23:28","guid":{"rendered":"https:\/\/sites.ncleg.gov\/ped\/?page_id=805"},"modified":"2022-07-26T14:32:59","modified_gmt":"2022-07-26T14:32:59","slug":"2016-04","status":"publish","type":"page","link":"https:\/\/sites.ncleg.gov\/ped\/2016-04\/","title":{"rendered":"Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016)"},"content":{"rendered":"\n<figure class=\"wp-block-image size-large is-resized h-50 w-50 float-right pl-4 pt-2\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/medicaid-logo-1.jpg\" alt=\"\" class=\"wp-image-834\" width=\"700\" height=\"600\"\/><\/figure>\n\n\n\n<p>In North Carolina, county departments of social services (county DSS offices) perform Medicaid eligibility determinations under the supervision of the Department of Health and Human Services (DHHS). County DSS offices failed to meet North Carolina\u2019s timeliness standard for processing Medicaid applications in Fiscal Years 2013\u201314 and 2014\u201315. The decrease in timeliness during these years coincided with a workload increase for county DSS offices stemming from conditions created by NC FAST implementation and enactment of the Affordable Care Act. NC FAST offers DHHS the opportunity to proactively manage and monitor county DSS offices, yet the department needs additional resources and authority to hold counties accountable. The General Assembly should authorize DHHS to intervene and take over county administration of Medicaid eligibility determinations when warranted; direct DHHS to report on the timeliness of determinations for Fiscal Years 2015\u201316 and 2016\u201317; and appropriate $300,000 to DHHS to support utilization of NC FAST data for performance measurement and evaluation.<\/p>\n\n\n\n<p><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/Medicaid_Eligibility_Report.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Final Report<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/Medicaid_Eligibility_Exec_Summary.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Executive Summary<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/Medicaid_Eligibility_Presentation.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Presentation<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/Medicaid_Eligibility_Handout.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Handout<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/Medicaid_Eligibility_Recommendations.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Recommendations<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><br>Relevant Legislation:<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/SB257Sec11H.21.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Session Law 2017-57, Section 11H.21<\/a>\u00a0directs DHHS to report annually on the timeliness of Medicaid eligibility determinations and on corrective actions conducted and planned for assisting county DSS offices with meeting timeliness standards.<\/li><li><a href=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/H1030v8.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Session Law 2016-94, Section 12H.17<\/a>\u00a0requires DHHS to report on the timeliness of Medicaid eligibility determinations for Fiscal Years 2015\u201316 and 2016\u201317; sets standards for timely decision and processing of applications; and establishes corrective action measures for county department of social services that fail to meet either average processing time standards, percentage processed timely standards, or both standards.<\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><br>Agency Actions:<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>DHHS submitted the required report for the 2016\u201317 fiscal year providing information on the timeliness of Medicaid eligibility determinations by county departments of social services.<\/li><li>Effective January 1, 2017, DHHS will monitor the timeliness of Medicaid eligibility determinations by county departments of social services and take corrective actions according to state law if necessary.<\/li><li>DHHS is in the process of filling the seven new positions authorized by the General Assembly to support improved utilization of NC FAST data to assist county departments of social services.<\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><br>Press Coverage:<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"http:\/\/www.northcarolinahealthnews.org\/2016\/04\/18\/report-shorthanded-swamped-county-workers-led-to-food-stamp-medicaid-delays\/\" target=\"_blank\" rel=\"noreferrer noopener\">North Carolina Health News<\/a><\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>In North Carolina, county departments of social services (county DSS offices) perform Medicaid eligibility determinations under the supervision of the Department of Health and Human Services (DHHS). County DSS offices failed to meet North Carolina\u2019s timeliness standard for processing Medicaid applications in Fiscal Years 2013\u201314 and 2014\u201315. The decrease in timeliness during these years coincided [&hellip;]<\/p>\n","protected":false},"author":30,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":"","_FSMCFIC_featured_image_hide":"","footnotes":""},"class_list":["post-805","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\r\n<title>Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016) - Program Evaluation Division<\/title>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/\" \/>\r\n<meta property=\"og:locale\" content=\"en_US\" \/>\r\n<meta property=\"og:type\" content=\"article\" \/>\r\n<meta property=\"og:title\" content=\"Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016) - Program Evaluation Division\" \/>\r\n<meta property=\"og:description\" content=\"In North Carolina, county departments of social services (county DSS offices) perform Medicaid eligibility determinations under the supervision of the Department of Health and Human Services (DHHS). County DSS offices failed to meet North Carolina\u2019s timeliness standard for processing Medicaid applications in Fiscal Years 2013\u201314 and 2014\u201315. The decrease in timeliness during these years coincided [&hellip;]\" \/>\r\n<meta property=\"og:url\" content=\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/\" \/>\r\n<meta property=\"og:site_name\" content=\"Program Evaluation Division\" \/>\r\n<meta property=\"article:modified_time\" content=\"2022-07-26T14:32:59+00:00\" \/>\r\n<meta property=\"og:image\" content=\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/medicaid-logo-1.jpg\" \/>\r\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\r\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\r\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/\",\"url\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/\",\"name\":\"Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016) - Program Evaluation Division\",\"isPartOf\":{\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/medicaid-logo-1.jpg\",\"datePublished\":\"2022-07-19T16:23:28+00:00\",\"dateModified\":\"2022-07-26T14:32:59+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/#primaryimage\",\"url\":\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/medicaid-logo-1.jpg\",\"contentUrl\":\"https:\/\/sites.ncleg.gov\/ped\/wp-content\/uploads\/sites\/11\/2022\/07\/medicaid-logo-1.jpg\",\"width\":420,\"height\":315},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/2016-04\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/sites.ncleg.gov\/ped\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/sites.ncleg.gov\/ped\/#website\",\"url\":\"https:\/\/sites.ncleg.gov\/ped\/\",\"name\":\"Program Evaluation Division\",\"description\":\"Just another NCGA Sites site\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/sites.ncleg.gov\/ped\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\r\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016) - Program Evaluation Division","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/sites.ncleg.gov\/ped\/2016-04\/","og_locale":"en_US","og_type":"article","og_title":"Timeliness of Medicaid Eligibility Determinations Declined Due to Challenges Imposed by NC FAST and Affordable Care Act Implementation (April 2016) - Program Evaluation Division","og_description":"In North Carolina, county departments of social services (county DSS offices) perform Medicaid eligibility determinations under the supervision of the Department of Health and Human Services (DHHS). County DSS offices failed to meet North Carolina\u2019s timeliness standard for processing Medicaid applications in Fiscal Years 2013\u201314 and 2014\u201315. 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