Charlie McGee

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Testimony: Florida wrongly cut people from Medicaid due to ‘computer error,' bad data

by Charlie McGee, The Tributary
July 30, 2024

A "computer error" and bad data from third-party vendors led Florida to wrongfully strip Medicaid coverage from residents, including new mothers who were denied postpartum care, federal testimony revealed Monday.

Will Roberts, a government operations consultant in the unit of Florida's Department of Children and Families that decides if people are eligible for new or continued Medicaid coverage, confirmed some widespread problems that led the state to wrongly deny insurance to eligible Floridians.

Plaintiffs relied on Roberts' testimony, the second so far in a bench trial overseen by U.S. District Judge Marcia Morales Howard, in their class-action challenge alleging Florida violated patients' rights when it removed medical coverage from millions of Floridians without proper notice.

Roberts confirmed that due to a “computer system problem” in the software that Florida jointly operates with Deloitte Consulting LLP, at least some eligible women in Florida have been denied a year of continuous Medicaid coverage that they were entitled to after giving birth.

The Florida legislature and Gov. Ron DeSantis expanded these women's Medicaid eligibility in 2021 from two months to 12 months of post-birth coverage, but the computer system DCF used to determine eligibility was not updated to comply with the expansion. Instead, the state automatically deemed women ineligible for coverage without giving them the context they'd need to challenge the decision.

Roberts did not say how many women lost coverage due to the state's failures. The agency became aware of the glitch in April 2023, he said. One of the mothers suing the state, he confirmed, was still being deprived of her post-birth coverage as of earlier this year.

“Previously, we gave women two months of post-partum coverage,” Roberts said. “That was changed to 12 months. From what I understand, when you refer to this glitch, the system had reverted back to giving women two months rather than the 12 months they were entitled to.”

He said the state has since fixed the error.

Florida Policy Institute chief executive officer Sadaf Knight told The Tributary in an email that public-health advocates have suspected the state hadn't properly implemented its post-birth Medicaid expansion since soon after it passed.

“Years later, we hear confirmation of what many on-the-ground health organizations and new parents have known to be true: the state agencies responsible for implementing this life-saving policy have failed to updates [sic] their computer systems or train frontline staff adequately,” Knight emailed. “A law only represents change for families if it is competently implemented."

His organization, he said, wants the Legislature to hold a hearing on the implementation of the Medicaid policy.

Every state in the U.S. began rapidly shaving people from their Medicaid rolls after the March 2023 end of a COVID-era emergency rule that stopped states from canceling residents' eligibility.

That effort to begin redetermining Medicaid eligibility is commonly known as the "unwinding".

Since the start of the Medicaid unwinding process, Florida has disenrolled beneficiaries at the 14th highest rate among all U.S. states, according to KFF's analysis of state-by-state data as of March.

The post-partum eligibility glitch wasn't the only system error the state encountered when it began its unwind, Roberts testified. Some errors affected other criteria for Medicaid eligibility.

“There were things that we found once unwinding started – unwinding, when we could start taking action on Medicaid eligibility – there were other system issues that we found,” he said, though he couldn't recall extensive detail on those other errors.

Separate from outright computer errors, Roberts' testimony on Monday also suggested that in at least some cases, DCF used and still uses outdated or outright inaccurate information to determine basic facts like a Medicaid recipient's household size and income level.

For example, one mother was deemed ineligible for Medicaid in July 2023 based on a claim her household made too much money per month. Roberts said DCF made that calculation based on outdated income data from a third-party source, Florida's State Wage Information Collection Agency.

DCF could've used far more recent data on that mother's income to make its calculation: two pay stubs that represented her household's income for June 2023, just one month prior to it determining her eligibility. Had it used that data, the mother would've kept her Medicaid.

In addition to wrongfully denying Medicaid coverage to eligible Floridians, the lawsuit alleges the state violated patients' due-process rights by not providing enough information about why they'd been deemed ineligble.

DCF declined a Tributary request for comment. Attorneys from the Florida Health Justice Project and National Health Law Program, who are representing the plaintiffs, also declined to comment.

The bench trial carries potentially sweeping implications for Florida's government.

If Judge Howard rules for the plaintiffs, she could order the state to reinstate Medicaid eligibility for hundreds of thousands – perhaps even millions – of people it has cut from the program and overhaul its system for making such cuts.

The handful of named plaintiffs at trial represent a class that includes anyone whom Florida has cut from Medicaid based on a claim that their income is too high since March 31, 2023. An official count of class members hasn't yet been determined in court, but it totals well above 100,000 Floridians and may come closer to a million people or more. All of these members could be eligible for relief if Howard rules as the plaintiffs hope she will.

Charlie McGee covers poverty and the safety net for The Tributary. He's also a Report for America corps member with The GroundTruth Project, an independent, nonpartisan, nonprofit news organization dedicated to supporting the next generation of journalists in the U.S. and worldwide. McGee may be reached at [email protected]. Follow him on Twitter @bycharliemcgee.

This article first appeared on The Tributary and is republished here under a Creative Commons license.

A “computer error” and bad data from third-party vendors led Florida to wrongfully strip Medicaid coverage from residents, court testimony revealed Monday.

At least some Florida women were denied Medicaid coverage that they were entitled to after giving birth.

Florida officials blamed technology failures and staffing problems for the state government wrongfully stripping Medicaid coverage from potentially hundreds of thousands of eligible families since early 2023, testimony in federal court revealed last week.

The race for an open seat on Florida's 4th Judicial Circuit Court bench has taken a partisan turn, as one candidate touts her conservative credentials while dark money groups flood mailboxes with attacks on her opponent.

Reginald Blount, Nahshon Nicks and Hank Rogers are campaigning to replace term-limited Warren Jones. If no candidate receives more than 50% of the vote in the Aug. 20 election, there will be a runoff with the leading two candidates in November. The election comes at a critical juncture for the district, which faces tough decisions on school consolidation and budget cuts while fending off challenges from charter and private school options.