Preventing additional respondent backlog

Abstract

Potential Healthy Connections Medicaid beneficiaries must apply and be deemed eligible for Medicaid coverage in one of the qualifying categories. If someone is deemed eligible for Medicaid, case documents are reviewed periodically or when there is a change in circumstance, such as finances, marital status etc. to ensure the person continues to meet the Medicaid criteria for coverage. If a Medicaid applicant or beneficiary disagrees with an eligibility decision, such as does not qualify or no longer qualifies for benefits, he/she has the right to file an appeal. Currently there is a backlog of eligibility appeal cases, and the goal would be to have no backlog.