Seniors complain new computer system kicking them off Medicaid

LAKE CHARLES, La. (KPLC) - A local apartment manager says some residents who have been on Medicaid for years are suddenly finding they no longer have the coverage they’ve had for years. She says some have received letters in the main, some have found out when prescriptions were no longer available at low prices and some received no notice.

Louisiana State Health officials say they are looking into complaints and committed to resolving them.

Advocates for senior citizens at Tower Oaks Apartments in Lake Charles, say a new computer system used by the Health Department is wreaking havoc on the lives of some seniors on Medicaid.

Tower Oaks Manager Shelly Young says some received letters saying they are no longer on Medicaid.

“People that need Medicaid are being denied the coverage that they’ve had sometimes 15 or 20 years and no circumstances have changed. it is a huge mess and somebody’s responsible for it and someone needs to do something to fix it,” said Young.

Young says it’s happening to people who are no doubt eligible. Like 70-year-old Billy Ewing who had polio as a child and has been on Medicaid for decades.

“I’m still in shock. if I don’t get help soon, I don’t know what’s going to happen,” said Ewing.

Eighty-four year old Betty Wilkins says she received calls from the pharmacy and a letter.

“I just felt, all of a sudden, oh my Lord, what’s going to happen. what in the world am I going to do? how am I going to survive?” said Wilkins.

Annette Tritico, who provides nursing services is concerned some seniors may go without medicine.

“As we well know, medication is vital for the patient’s care,” she said.

And Young says Medicare insurance premiums, normally paid by Medicaid, are now to be deducted from some residents’ social security checks. She says sometimes they take two or three months of premiums, in advance and from their social security or disability checks.

“It’s causing them more health issues because of the stress and the turmoil that they are going through, worrying about how are they going to pay for their food if they’re having to pay for their Medicare premium,” said Young.

She says, lately, she spends about six hours a day trying to help seniors do paperwork to try to regain services lost or denied. Again, she says these are seniors whose circumstances have not changed, so their eligibility should remain the same.

State Health officials say they say are committed to reaching out to the people at Tower Oaks to find out what has happened and maintain coverage for those eligible.

Health officials confirm that a new “eligibility system” (computer system) was implemented in November 2018. The spokesperson explained that it has an “auto closure” feature that results in automatic closure if the system determines a person is no longer eligible. However, the spokesperson says no one is terminated without due process and appeal rights.

Also, Health officials say they are committed to reaching out to the manager and residents at Tower Oaks to find out what has happened and help them maintain their coverage if they remain eligible.

We also contacted the Louisiana Department of Insurance which has a Senior Health Insurance Information Program (SHIIP.)

Deputy Commissioner for Public Affairs, John Tobler, says he spoke to coordinators who are working with constitutents.

“We are aware of these issues and are working to assist those impacted by the changes in the DHH systems as outlined. Because these programs are administered by other federal and state agencies, we are limited by the level of access we have to their systems, but are doing what we can to help manually. The LDI SHIIP team continues to work with our partners to provide assistance in moving constituent needs forward,” said Tobler.

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