Latest news with #EOHHS
Boston Globe
3 days ago
- Health
- Boston Globe
In R.I., approximately 700 enrolled in Medicaid may lose coverage due to error
Advertisement At Get Rhode Island News Alerts Sign up to get breaking news and interesting stories from Rhode Island in your inbox each weekday. Enter Email Sign Up Beginning this month, Medicaid will begin using the correct income limit to determine eligibility for new applicants, White wrote. The corrected income limit will apply to current beneficiaries when their eligibility is reviewed 'either during the person's annual Medicaid redetermination (or Medicaid renewal) or during a quarterly post-eligibility verification (PEV) process.' 'Roughly 700 parents/caretakers currently enrolled in Medicaid fall between 138 percent and 141 percent FPL and are expected to be impacted by this update,' White wrote. 'These members will retain their Medicaid benefits until their cases are reviewed for eligibility.' Advertisement During the 2023 state fiscal year, Rhode Island's Medicaid program provided full medical coverage to 389,000 people at some point during the year, and another 12,000 residents received limited benefits from Medicaid, according to the state's The income limit error was discovered during a review of the Medicaid program to ensure it complies with federal and state regulations, according to White. The EOHHS 'believes the initial error predates the McKee Administration and likely occurred in 2014,' White wrote. 'Staff originally identified the issue as we prepared for the [state fiscal year] 2025 budget and took time over the proceeding months to fully understand and interpret the relevant documents, to conduct data analysis to understand the member impact, and to ensure that a clear transition pathway would be in place to mitigate harm to those losing coverage,' White wrote. The income limit correction is necessary because state Medicaid programs must be administered according to federal rules and the agreements the state has made with the federal Centers for Medicare and Medicaid Services, according to White. The state is not allowed to spend Medicaid money 'for a certain group at a certain income level' without federal approval, White wrote. 'All Rhode Islanders deserve access to affordable health insurance,' Senate President Valarie Lawson said in a statement on Tuesday. 'My understanding is that EOHHS will allow coverage to continue for those enrolled in error until the expiration period. We hope and expect that they will review every circumstance and provide the assistance necessary to avoid disruptions in coverage.' Advertisement House Speaker K. Joseph Shekarchi called the matter 'an example of why administrative departments need to do the fundamental things right the first time.' 'Errors like these have real consequences,' Shekarchi said in a statement. Rhode Island Attorney General Peter Neronha, who has been a 'These are working people that are struggling to make ends meet every single day,' Neronha said in a statement. 'Mind you, this is happening as the federal government is moving to make massive cuts to Medicaid, and our state government is scrambling to find solutions to a health care crisis that we've known about for quite some time. 'We must fix health care in Rhode Island now, and that obviously includes keeping Rhode Islanders insured,' Neronha added. Those who are impacted by the income limit correction will receive a 'benefits decision notice' informing them they are no longer eligible and whether they are eligible for a Qualified Health Plan through HealthSource RI, the state's health care exchange, according to White. Some, White said, may qualify for auto-enrollment through HealthSource RI. According to White, individuals at the corrected income level who are eligible for Advanced Premium Tax Credits can enroll in 'some' silver-level health plans 'with a small monthly premium cost,' thanks to federal subsidies. White noted, however, that after this year it is 'very likely that federal subsidies will reduce, meaning that the monthly premium would increase.' Advertisement Yet, 'plans available to this group also have reduced cost-sharing, making out-of-pocket costs much more affordable for medical services,' White wrote. Christopher Gavin can be reached at
Yahoo
4 days ago
- Business
- Yahoo
700 Rhode Islanders to lose Medicaid coverage; state blames old mistake
PROVIDENCE, R.I. (WPRI) — While Democrats are fighting proposed Medicaid cuts at the federal level, Rhode Islanders are facing their own cuts on the state level due to a change in the program's income limit. 'I think the only reason that a state would be motivated to do that is to save money,' said Sam Salganik, executive director of RIPIN, a nonprofit that helps people navigate the health care system. Salganik said the state used to have an income limit of about $19 an hour for a single parent of two. But he said the state is now lowering that to roughly $18.30. REPORT: 366K+ Rhode Islanders would be impacted by proposed Medicaid cuts A spokesperson for the state's Executive Office of Health and Human Services (EOHHS) said 700 parents and caretakers will lose Medicaid coverage because of the new income limit, which was put in place due to a mistake made years ago. According to the state agency, it will take effect for new patients beginning this month. 'If [the U.S. Centers for Medicare and Medicaid Services (CMS)] has not approved the state to spend federal Medicaid money for a certain group at a certain income level, the state is not allowed to do so,' spokesperson Kerri White wrote. But Salganik said the federal income limit is the floor, not the ceiling. 'States always have the flexibility to have higher income limits than the minimums that were established by the Affordable Care Act, as long as it's part of the approved state Medicaid plan,' he explained. 'And this has been part of the approved state Medicaid plan for many, many years.' Salganik is also concerned this is being done through agency regulations rather than the legislative budget process. 'This is an example of why administrative departments need to do the fundamental things right the first time,' House Speaker Joe Shekarchi wrote in a statement to 12 News. 'Errors like these have real consequences.' MORE: Suspected Medicaid fraud in RI sparks criminal probe, proposed changes EOHHS said affected Medicaid recipients will be sent a letter, but they'll be able to keep their benefits until their annual renewal, or until a quarterly post-eligibility verification process. White said the change will save $1.9 million in state funds and $4.5 million when federal money is included. And while EOHHS said people will be able to buy coverage through HealthSource RI, Salgank said that will still cost low-income parents hundreds of dollars each year, if not more. 'It's just one more cost that is really difficult for them to afford,' he said. Download the and apps to get breaking news and weather alerts. Watch or with the new . Follow us on social media: Close Thanks for signing up! Watch for us in your inbox. Subscribe Now Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
USA Today
05-02-2025
- Politics
- USA Today
Numbers show RI undocumented immigrants a small slice of those getting benefits. What we know.
Numbers show RI undocumented immigrants a small slice of those getting benefits. What we know. Show Caption Hide Caption President Trump's radical immigration agenda takes shape On Day 1 of his presidency, Trump sought to make good on his campaign promise to curb illegal immigration. PROVIDENCE – President Donald Trump's threat to end birthright citizenship and conduct "mass deportations" has instilled fear and uncertainty into a population that is now driving Rhode Island roads legally, paying taxes and growing their families, some with state-paid – and legislature approved – health benefits. How many of these undocumented immigrants are now living with the fear that all this will be snatched away? Unclear. At one point, a group calling itself the "Federation for American Immigration Reform" pegged the number at 35,000, based on an extrapolation of an estimated national number. The truth is: there is no reliable count. But the numbers that are available indicate that undocumented immigrants – described in state law as those "unable to establish legal presence in the United States" – are just a tiny slice of those who are getting Rhode Island benefits. What do we know about them? Thousands of undocumented immigrants have intersected with state government in Rhode Island in recent years in their pursuit of "driver privilege cards," tax ID numbers that enable them to report their income and pay taxes and in some limited cases, state-subsidized benefits. Here, at a glance, is the picture that can be drawn from the privileges and benefits Rhode Island lawmakers have approved: MEDICAID There were 5,090 undocumented women and children on the state-paid Medicaid rolls as of Dec. 5, when the Executive Office of Health & Human Services (EOHHS) ran the query for The Journal. That number included 486 pregnant or postpartum women, 4,598 children and six infants. Medicaid payments on behalf of those without Social Security numbers totalled $55.4 million last year, including the $16,106,050 paid for those officially determined to be undocumented immigrants. Putting that $16.1 million in context, it's just a tiny piece of Rhode Island's Medicaid budget, which totaled $3.9 billion during the last fiscal year. Kerri White, spokesperson for EOHHS, explained: "The only undocumented people in Rhode Island who qualify for coverage are either those who are currently pregnant or postpartum" or children covered by the Cover All Kids law adopted in 2022 to provide state-paid health insurance to all children in low-income families, regardless of their immigration status. Removing any doubt, White said: The coverage for these undocumented women and children "is paid for by Rhode Island state general revenue only (not by federal funding)." OTHER PUBLIC ASSISTANCE PROGRAMS As of Nov. 26, 2024, 1,625 people without verified Social Security numbers had received publicly-subsidized benefits from other Rhode Island assistance programs for low-income people, including: RI Works, Refugee Cash Assistance, SNAP and, in a handful of cases, for burials. They fell into two categories: Those with what the state calls verified "alien status" (1,622) and those without (3). Over the years, they have included: newborns, recent legal immigrants, asylum seekers, refugees, fostered or adopted children and whoever else might not have a SSN at the time of application. As explained by Department of Human Services spokesperson James Beardsworth, the numbers include individuals with "qualified non-citizen status" which means the individual is in the country legally and is entitled to certain benefits even if there is no SSN." The cost of providing benefits to those with a verified "non-citizen status" was $12,066,543 at that point in the year and only $1,058 for those with an "unverified status." Of note: Beardsworth said state agencies are banned from denying some benefits because an individual does not have a Social Security number. For example: The federal regulations governing the Supplemental Nutrition Assistance Program (SNAP) prohibit a state agency from delaying the approval and issuance of SNAP benefits to verify a Social Security number to a household that is otherwise eligible. Similarly, state agencies cannot 'deny, delay, or discontinue assistance' for cash assiatnce from the state's RIWorks program 'pending the issuance or verification' of SSNs if the applicant or recipients have applied. Federal regulations governing the Refugee Cash Assistance program prohibit state agencies from asking applicants for a SSN. General Public Assistance (GPA) burial assistance does not require the submission nor verification of a SSN. Putting these numbers in perspective, the current number of enrollees in Medicaid is 305,463 with full benefits and 12,000 receiving partial benefits; SNAP, approximately 40,000 people; assistance to needy families, 8,323; refugee cash assistance, 750 and General Public Assistance, 533. TAX ID NUMBERS Based on the Division of Taxation analysis, the number of state personal income tax filers using an Individual Taxpayer Identification Number (ITIN) is 9,174, according to spokesman Paul Grimaldi. The "tax identification number" for most people in the United States is their Social Security number (SSN). But a "foreign person, who doesn't have and can't get a SSN, must use an individual taxpayer identification number (ITIN),'' according to the IRS. While the 9,174 may, in fact, include undocumented immigrants, Grimaldi notes, they are not the only ones reflected in the count. They may be, for example, a foreign national not eligible to receive a SSN but has "reportable income" other than wages. DRIVERS PRIVILEGE CARDS State officials say they do not keep any count of the look-alike drivers' licenses created specifically for people who are "unable to establish legal presence in the United States." Gov. Dan McKee cited a number – "3,000" – during an appearance on Gene Valicenti's WPRO radio talk show. But when pressed, the administrators of the Rhode Island DMV insisted they did not know. Who is eligible for a "driver privilege permit"? More: How many driver privilege cards have been given out by the DMV? Why officials can't say. With the approval of state lawmakers, "driver privilege cards" have been available since July 2023 to individuals "unable to establish [their] legal presence in the United States," who can nevertheless produce proof of their residency and identity, as well as a personal income tax return for the previous year that documents they were here working and paying taxes – or are the dependent of someone who was. State law does not bar the DMV from keeping a running count of the number handed out. But the McKee Administration has taken the position that it does. "The legislative intent when the statute was passed was to ensure that [Drivers Privilege Cards] were indistinguishable from non-REAL ID credentials [so] that individuals holding [the cards] would not be targeted," Grimaldi said. But the DMV was willing to disclose in November, after multiple requests from The Journal around what is public information, that in the 17 months the DPC program has been active, here have been: 12,418 reservations 2,036 no-shows for reservations Roughly 10,382 separate privilege card reservations But even that 10,382 number does not accurately represent the number issued, Grimaldi explained because "many people" fail to show up for their first reservations. Or they may book multiple reservations. Or they may not have the right paperwork, or may not pass the test to get the privilege card, requiring "additional reservations." Current privilege cardholders are now starting to make reservations to renew their cards, which adds to the queue but does not, Grimaldi notes, "add to the total number of credentials in circulation."
Yahoo
04-02-2025
- Health
- Yahoo
Disputed $15.5 billion R.I. Medicaid contract canceled amid new federal requirements
Rhode Island officials have scrapped a tentatively awarded, $15.5 billion contract to manage the state's Medicaid program. Blue Cross Blue Shield of Rhode Island, pictured, was one of four vendors that competed for a piece of the contract. (Photo by Alexander Castro/Rhode Island Current) Rhode Island officials have scrapped a tentative, $15.5 billion, five-year contract to manage the state Medicaid program amid new federal rules, Kerri White, a spokesperson for the Rhode Island Executive Office of Health and Human Services (EOHHS), confirmed via email on Tuesday. Instead, the state will extend its existing Medicaid contract to June 30, 2026 — a year later than it was scheduled to end. The massive contract, equal to 25% of the state's annual budget, determines which vendors run the state's medical assistance program for nearly 320,000 Rhode Islanders. White cited updated federal regulations and timeline requirements under the Centers for Medicare and Medicaid Services (CMS) as the reason why the state decided to cancel the award. 'The model contract must be redrafted to align with these changes and any additional federal changes the new administration enacts,' White said. President Donald Trump has issued a string of executive orders since taking office that could reshape state Medicaid programs, though details remain fuzzy. His attempt to freeze federal funding — blocked temporarily by federal judges in Rhode Island and D.C. — could also have sweeping consequences for Medicaid recipients if implemented. A tentative award announced by state officials July 16 would have split the new, five-year contract between two companies — Neighborhood Health Plan of Rhode Island and UnitedHealthcare of New England. Two other bids, submitted by Blue Cross Blue Shield of Rhode Island and Tufts Public Health Plans, Inc., were initially disqualified because they did not meet a minimum score set by a review committee. The losing companies filed separate appeals of the state's decision, pointing to flaws in the scoring criteria and the makeup of the review committee, which Blue Cross alleged unfairly included a former employee of UnitedHealthcare. Based on their claims, state administrators agreed in October to restart its review of all four proposals. Chief Purchasing Officer Jonathan Womer, who also heads the Rhode Island Department of Administration, acknowledged in an Oct. 15 letter that the state was too vague in explaining the scores awarded by the original, five-person review committee. Womer called for a new review committee to reevaluate all four proposals, bringing in a non-government subject matter expert to suggest potential changes to scoring criteria. The appeals 'had no bearing' on the decision to cancel the existing award, White said. EOHHS will work with the state purchasing division to determine next steps in issuing a new solicitation, White said. United and Neighborhood, along with Tufts, have been managing Medicaid services under the existing state contract, awarded in 2016. In fiscal 2022, the most recent data available, Neighborhood was responsible for more than half of the state's Medicaid patients, while UnitedHealthcare had 30% and Tufts had 5%. The remaining 6% was paid directly to providers through a fee-for-service model, rather than through the managed care organizations. Peter Marino, president and CEO of Neighborhood, said the company is still committed to serving Rhode Island residents. 'Neighborhood is confident in our expertise and capabilities as a nation-leading health plan, and we remain a dedicated partner to EOHHS in serving Rhode Islanders,' Marino said in an emailed statement Tuesday. 'We are steadfast in our commitment to ensuring access to healthcare and social services for the 220,000 members Neighborhood serves, as the largest Medicaid and Exchange based health plan and the only Medicare-Medicaid plan in Rhode Island.' Kathleen Makela, a spokesperson for Tufts' parent company, Point32Health, said the company was pleased with the state's decision to cancel the award. 'We remain strongly committed to Rhode Island and to meeting the unique and diverse health needs of all Rhode Islanders,' Makela said in an email on Tuesday. 'We believe that it's important that our 15,000 RI Together members continue to have access to Tufts Health Plan's high-quality health care services.' Blue Cross acknowledged, but did not immediately respond to, requests for comment Tuesday. UnitedHealthcare did not immediately respond to inquiries for comment. The contract cancellation does not require any actions by or effects on Rhode Island Medicaid recipients, White said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
