MuskogeePhoenix.com, Muskogee, OK

Local News

September 23, 2012

Thousands lose SoonerCare

Computer glitch leads to enrollment errors in state program

A computer error has caused thousands of Oklahomans to lose their health insurance coverage from the state.

Oklahoma Health Care Authority officials said Friday a computer glitch prevented the agency from verifying income of families who applied online for SoonerCare, Oklahoma’s Medicaid program.

The computer error was not discovered for more than a year. As a result of correcting the error, thousands of children and adults have been dropped from SoonerCare.

“That leaves these more than 1,000 people in our area, about 8,000 people statewide, suddenly without health care coverage,” said State Rep. Jerry McPeak, D-Warner.

When McPeak learned of the error, he inquired about the situation with OHCA officials and received the following information:

• In June 2012, the OHCA sent out 12,000 letters notifying clients they were not eligible and their benefits were terminated. About 4,000 were able to get their benefits reinstated.

• Of the 8,000 who were dropped, more than 4,900 were children, and the rest were adults, ages 19 to 63.

• Muskogee, McIntosh, Cherokee and Wagoner counties saw more than 3,000 people dropped in June, July and August. The county breakdown provided by the OHCA does not specify if those 3,000 were dropped because they did not reapply for coverage when it lapsed, had an income change, or were among the 8,000 who should never have been insured.

• The number of people who lost coverage in Muskogee County equaled the number of people in the other three counties combined.

To qualify for SoonerCare, individuals must earn less than 185 percent of the federal poverty level for the number of people in their family.

The OHCA reported that around November 2010 information system employees noticed a number of terminations being issued that were questionable, so they contacted Hewlett-Packard to check for problems with the system.

HP noted a fault and subsequently removed the “catches” in place on income verification but did not notify the OHCA, McPeak was told.

The removal of the “catches” prevented OHCA from being able to properly confirm an applicant’s self-reported income through the Oklahoma Employment Security Commission.

OHCA officials told McPeak’s office they are 100 percent confident that the system is up and running properly now.

It’s unknown if the OHCA can or will ask those who used SoonerCare — even if they did not financially qualify — to repay the state for the services they used.

“I have not heard anything to that extent,” said OHCA spokesman Carter Kimble. “There is a certain breaking point where it doesn’t make sense to go after that — especially since we’re still dealing with low-income folks.”

There are options for children’s health care for those who don’t qualify any longer for SoonerCare, but not many.

Families can purchase private insurance. However, for those who can’t afford private insurance rates, or don’t have insurance offered through their employers, a state-funded insurance program for all ages could help.

Insure Oklahoma, O-Epic, is a state-funded health insurance plan, which some may qualify for if they earn 200 percent of the federal poverty level or less and work for an employer who employs less than 99 people. The premium is based on income, and children and adults may qualify.

But those restrictions may not help all of the people who lost their SoonerCare coverage.

McPeak said even Oklahoma state employees are sometimes so underpaid they qualify for state assistance.

“We have people in the Department of Corrections that make so little, with three kids they qualify for all that,” McPeak said.

Reach Wendy Burton at (918) 684-2926 or wburton@muskogeephoenix.com.

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