On January 1, 2014, expansions to Connecticut’s Medicaid system came into action. This expansion aims to include low-income adults as a new group that will receive Medicaid coverage under Access Health CT, which is Connecticut’s state-based marketplace. This includes low-income adults who make up to 138 percent of the federal poverty level, and are affected now by the Affordable Care Act’s expansion of Medicaid coverage. However, Connecticut’s attempt to extend benefits to this new class of Medicaid members has recently reached a snag. In fact, the federal government has sent deferral letters to the Connecticut state government within which the federal government has refused to reimburse Connecticut for the additional costs associated with providing Medicaid coverage for the new class of low-income adults.
The Federal Government’s Deferral Notice
The federal government’s refusal to reimburse Connecticut for its first quarter Medicaid expansion expenses of $249.2 million revolves around technical disputes about eligibility. The second quarter deadline for federal payments for Medicaid are due next month, but it is currently unclear whether such payment will be received within the required timeframe. The federal government’s refusal to make payments comes as a shock for two main reasons. First, Connecticut was one of the few states to immediately embrace the ACA’s expansion of Medicaid to provide medical services for the low-income adults who are now covered. One might have assumed that such early support, at a time when other state’s had spoken out against the ACA, would have been awarded with prompt payment.
Second, Connecticut state officials have stated that in March of this year, the federal government had already agreed to reimburse Connecticut for 100 percent of all services that were to be provided to newly eligible Medicaid members. This preliminary agreement covered all payments/services the state made from January through March of 2014 for new Medicaid members. State officials believed that the first quarter reimbursement payments from the federal government were supposed to be made before approval of the additional amendments to reimbursement eligibility requirements that were sought by the federal government.
However, the reality is that the Connecticut Social Services Department received a deferral notice in July for the $249.2 million in medical expenses that had already been provided to the new Medicaid members. During this time period, Connecticut state officials had been working to gather the relevant information regarding the amendments to the eligibility requirements. The refusal to reimburse the Connecticut government for services and payments that have already been made puts the state in a serious bind. Though the Connecticut government is attempting to work with the federal government to resolve the issue, the state could end up being on the hook for $249.2 million, which would greatly impede the Connecticut government’s ability to deliver other relevant and just as important social services.
We Can Help You in Your Case
Need professional legal assistance with accessing Medicaid benefits, or filing a denial of Medicaid claim? Contact the Fairfield County Medicaid attorneys at our law firm. We can provide more information on Medicaid eligibility and answer any other legal questions you may have.