North Carolina Department of Health & Human Services. NC FAST Update. October 29, 2014

Transcription

1 North Carolina Department of Health & Human Services NC FAST Update October 29,

2 North Carolina Department of Health & Human Services FNS Processing 2

3 FNS Application Processing Status Counties successfully met the Feb. 10 and March 31 USDA FNS processing deadlines. *There will always be some applications that remain pending with good cause. As of September 30 th, 807 untimely pending applications remained. 3

4 FNS Recertification Workload Snapshot Counties successfully met Feb. 10 and March 31 USDA FNS processing deadlines. *There will always be some recertifications that remain pending with good cause. As of September 30 th, 908 untimely pending recertifications remained. 4

5 North Carolina Department of Health & Human Services Medicaid Processing 5

6 Overall Medicaid Applications Processed 83% of new applications were processed in NC FAST to date in October, with 17% processed in EIS. Overall Medicaid Apps includes Adult Medicaid (includes Special Assistance and Refugee Assistance), Traditional Family and Children s Medicaid, and MAGI Family and Children s Medicaid (including those from HealthCare.gov). *SDX and SA products will be scheduled for release to NC FAST on a county by county basis. **Data as of October 22 nd 6

7 Adult Medicaid Applications Processed *SDX and SA products will be scheduled for release to NC FAST on a county by county basis **Data as of October 22 nd 7

8 Traditional F&C Medicaid Applications Processed *The historical average should be compared against traditional Family and Children s Medicaid, MAGI Family and Children s Medicaid and HealthCare.Gov MAGI Applications (January and beyond numbers represented on this page and the two following. **Data as of October 22 nd 8

9 NC-Based MAGI Applications Processed *The historical average on the traditional Family and Children's should be compared against traditional Family and Children s Medicaid, MAGI Family and Children s Medicaid and HealthCare.Gov MAGI Applications. **Data as of October 22 nd 9

10 HealthCare.Gov Applications Processed *The historical average on the traditional Family and Children's should be compared against traditional Family and Children s Medicaid, MAGI Family and Children s Medicaid and HealthCare.Gov MAGI Applications. **Data as of October 22 nd 10

11 North Carolina Department of Health & Human Services Special Assistance, Refugee Assistance and Work First Processing 11

12 Special Assistance Applications Processed *SDX and SA products will be scheduled for release to NC FAST on a county by county basis. **Data as of October 22 nd 12

13 Refugee Assistance Applications Processed *Data as of October 22 nd 13

14 Work First Applications Processed *Data as of October 22 nd 14

15 North Carolina Department of Health & Human Services Health Care Reform, Open Enrollment and Current Medicaid Processing Details 15

16 Health Care Reform Application Summary Platform HealthCare Reform Applications through May 28 th HealthCare Reform Applications through June 25 th HealthCare Reform Applications through July 30 th HealthCare Reform Applications through Aug 27 th HealthCare Reform Applications through Sep 30 th HealthCare Reform Applications through Oct 22 nd Note: Applications received through internet portal. 33,261 36,569 40,697 44,243 48,337 50,922 Note: Applications received at a county DSS agency. 135, , , , , ,533 Total: 169, , , , , ,455 16

17 HealthCare.gov Applications by Status 100% of applications from Open Enrollment submitted at healthcare.gov that will be sent to NC have been transferred to NC FAST. 97% of those applications have been fully processed by the state. 9% of the fully processed applications were approved for Medicaid; the remainder were denied, withdrawn, or transferred. Status of Healthcare.gov/FFM Applications Application Count Application % FFM applications received by NC FAST 92, % Total FFM applications still being processed 3,092 3% Total FFM applications fully processed 89,356 97% Applications approved for Medicaid ("woodwork effect") 8,433 9% Applications denied/withdrawn/transferred 80,923 91% Duplicate Application 20,179 25% Already on Medicaid (subset of duplicates) 12,199 15% Application processed and denied or withdrawn 60,614 75% Application from out of state 130 0% **As of Oct 23 Approved: Applications approved for MAGI-based programs from the FFM Denied: Applications denied for MAGI-based programs from the FFM (this includes duplicates, out of state applications and applicants already receiving Medicaid.) Withdrawn: Applicant requested to withdraw the application Open Enrollment will begin again on November 15 th, Applications received via HealthCare.gov will be transferred automatically to local county DSS offices for processing. They will not be held and screened at the State level as was done last year. 17

18 Pending Medicaid Applications There are currently 11,845 pending Medicaid applications in NC FAST and EIS that are beyond standard processing time (Compared to 2014 peak of 104,070): FFM Applications: 1,686 (Compared to 2014 peak of 45,058) NC FAST MAGI Applications: 3,630 (Compared to 2014 peak of 31,890) NC FAST Traditional Applications: 5,004 (Compared to 2014 peak of 20,938) EIS: 1,525 (Compared to 2014 peak of 9,051) *Data as of October 22 nd 18

19 Total Untimely Pending Medicaid Applications We continue to monitor statewide and individual county progress in working through untimely pending Medicaid applications. Since the peak of untimely pending applications at the beginning of June, counties have been successful in lowering the overall backlog by 89% which includes a reduction of approximately 92,000 untimely pending applications. A significant portion (45%) of the untimely pending Medicaid applications are directly related to Affordable Care Act changes. *There will always be some applications that remain pending with good cause. 19

20 Breakdown of Untimely Pending Apps There are 1,686 untimely pending Medicaid applications from the FFM. There are 3,630 untimely pending Medicaid applications for MAGI Programs received online or in county DSS offices. *Note: For the week ending Sept. 3, an adjustment was made to the reporting for NC-Based MAGI pending applications. Previously, reports used the received date to calculate timeliness. The adjusted reports now use the application date. As a result, there was an increase in the number of NC-Based MAGI applications being counted as untimely this week. 20

21 Breakdown of Untimely Pending Apps There are 1,525 untimely pending Medicaid applications in EIS for Traditional Programs. There are 5,004 untimely pending Medicaid applications in NC FAST for Traditional Programs. *Note: Pilot county pending cases that were converted from EIS to NC FAST in December were erroneously being counted as untimely and unprocessed through the week of May 26 th. This is the primary source of the significant drop in EIS untimely applications between the May 28 and June 4 counts. 21

22 County Untimely Pending Medicaid Apps- Most Impacted Counties by Total Untimely Change from Last Week Total Untimely Pending Applications (as of 10/15) Total Untimely Pending Applications (as of 10/22) Untimely HealthCare.gov Apps (as of 10/22) Historical Avg. # of Medicaid Apps Processed (in EIS) Total Apps Processed in Current Month (as of 10/22) Wake 490 4,285 3, ,987 5,016 Mecklenburg -3 1,432 1, ,704 5,595 Forsyth 11 1,077 1, ,976 2,541 Robeson ,628 1,295 Guilford ,486 2,578 Cumberland ,708 2,861 Columbus Pitt , Onslow , Union , Caldwell Buncombe ,195 4,373 Iredell ,157 1,261 Gaston ,141 1,538 New Hanover ,398 1,119 Durham ,145 2,142 Randolph , Alamance , Hoke Davie TOTAL ,236 9,724 1,592 39,396 36,269 Of all Medicaid applications beyond the standard processing time, 82% are from 20 counties. 16% of the pending untimely applications are from HealthCare.gov The following county is no longer considered a Most Impacted county: Harnett The following county has been added to the Most Impacted counties list this week: Hoke *There will always be some applications that remain pending with good cause. 22

23 Untimely Pending Medicaid Apps- Most Impacted Counties by Volume County Current Untimely Medicaid Applications as a % of Typical Monthly Application Volume Total Untimely Pending Applications (as of 10/22) *There will always be some applications that remain pending with good cause. Historical Avg. # of Medicaid Apps Processed (in EIS) Total Apps Processed in Current Month (as of 10/22) Wake 76% 3,795 4,987 5,016 Graham 76% Columbus 48% Robeson 39% 630 1,628 1,295 Forsyth 36% 1,066 2,976 2,541 Davie 35% Pamlico 34% Hertford 29% Washington 29% Hoke 23% Mecklenburg 21% 1,435 6,704 5,595 Hyde 21% Caldwell 20% Pitt 20% 228 1, Onslow 19% 226 1, Jones 18% Jackson 16% Madison 16% Union 13% 169 1, Iredell 12% 139 1,157 1,261 TOTAL 24% 8,560 24,030 21,043 23

24 Medicaid Recertifications Processed Historically, the average number of recertifications processed each month in EIS is 82,191. The average overdue recertifications per month is 7,166, and the average extended per month is 6,578. December through April totals are increased due to the Medicaid Waiver extensions. *Data as of October 22 nd 24

25 Pending Medicaid Recertifications A total of 378,350 Medicaid recertifications are pending through the end of the calendar year. *Data as of October 22 nd 25

26 Medicaid Recertification Workload The current target plan is to clear Medicaid Recertifications by December 31. *Data as of October 22 nd 26

27 Pending Medicaid Recerts - Most Impacted Counties County Total Recerts Due through December October Recerts Due as of 10/22 (Originally Due and Extended Due) November Recerts Due as of 10/22 (Originally Due) December Recerts Due as of 10/22 (Originally Due) Past Due Recerts as of 10/22 "Typical" Monthly Average of Recerts Due Recerts Due in Oct (as of 10/22) as Percentage of "Typical" Monthly Average Orange 7,699 6, % Johnston 16,160 12,321 2,059 1, , % Harnett 10,768 7,581 1,484 1, , % Watauga 2,075 1, % New Hanover 12,384 8,045 2,085 2, , % Rowan 12,361 7,824 2,011 2, , % Buncombe 15,530 9,968 2,223 3, , % Pamlico % Sampson 7,896 4, , , % Randolph 9,583 5,599 1,889 1, , % Granville 3,226 1, % Polk % Scotland 2,527 1, % Alamance 9,810 4,840 2,117 2, , % Pender 2,713 1, % Wake 22,781 10,832 7,341 4, , % Cleveland 7,212 3,438 1,564 2, , % Jackson 1, % Union 5,306 2,390 1,345 1, , % Franklin 2,722 1, % TOTAL 153,880 92,558 29,475 30,751 1,096 30, % Statewide 378, , , ,346 2, , % The following counties are no longer considered a Most Impacted county: Onslow, Vance The following counties have been added to the Most Impacted counties list this week: Franklin, Pender 27

28 North Carolina Department of Health & Human Services Hard Launch Schedule 28

29 Remaining Medicaid Implementation Timeline 7/1/2014 Group 1 Enters Hard Launch Stage 1 8/1/2014 Groups 2-5 Enter Hard Launch Stage 1 8/4/2014 Group 1 Enters Hard Launch Stage 2 9/8/2014 Group 2 Enters Hard Launch Stage 2 10/6/2014 Group 3 Enters Hard Launch Stage 2 10/20/2014 Group 4 Enters Hard Launch Stage 2 11/17/2014 All Counties 11/3/2014 SDX Hard Launch Stage 2 Group 5 Enters Hard Launch Stage 2 7/1/2014 8/1/2014 9/1/ /1/ /1/ /1/2014 6/1/ /31/2014 Pilots Group 1 Counties Stage 1 Group 2-5 Counties Group 3-5 Counties Group 4-5 Counties Group 5 Counties Stage 2 Group 1 Counties Group 1-2 Counties Group 1-3 Counties Group 1-4 Counties All Counties SDX = Current Position *Data as of October 22 nd Existing Clients in NC FAST All Counties All New SDX Clients Pilot Group 4 Counties All New SDX Clients All Counties All SDX All Counties 29

30 Balanced Conversions Based on Caseloads Swain Graham Cherokee Macon Clay Madison Buncombe Avery McDowell Polk Rutherford Watauga Burke Ashe Caldwell Alleghany Wilkes Catawba Lincoln Gaston Iredell Surry Yadkin Davie Rowan Cabarrus Union Stokes Forsyth Davidson Stanly Anson Rockingham Guilford Randolph Alamance Moore Caswell Scot land Chatham Lee Hoke Orange Person Harnett Wake Franklin Johnston Sampson Warren Nash Wilson Wayne Duplin Halifax Greene Lenoir Northampton Pitt Jones Onslow Martin Craven Hertford Bertie Beaufort Carteret Gates Tyrrell Hyde Dare Conversion Groups Robeson Bladen Pender Pilot - December 9 th (2013) Columbus Group 1 - August 4 th Brunswick Group 2 - September 8 th Group 3 - October 6 th Group 4 - October 20 th Group 5- November 3 rd Group Counties Cases Pilot 4 14,410 Group ,201 Group ,511 Group ,478 Group ,362 Group ,315 Total 100 1,744,277 *Note: Counties allocated for each hard launch are tentative and subject to change based on a variety of factors, including current county status of new application and recertification processing for both FNS and Medicaid. *Data as of October 22 nd 30

31 Legacy System Application Shut Down Schedule The ability to process applications in the Legacy system is being slowly revoked by county depending upon their place in the Hard Launch schedule and by program, over time. Targeted Date Thursday, 7/3 Friday, 10/17 Friday, 10/24 Friday, 10/31 Programs Counties Status AAF, MAF, MIC, MPW, MRF, RRF AAF, MAF, MPW, MRF, RRF, MSB, SCD IAS, HSF AAF, MAF, MPW, MRF, RRF, MSB, SCD, IAS, HSF Pilot Hard Launch Counties Pilot through Group 4 Hard Launch Counties Pilot through Group 4 Group 5 Hard Launch Counties Complete Complete Complete Friday, 11/7 MIC (MIC-L workaround) Friday, 12/5 SAA, SAD, MAD (LIS), MAA (LIS), MQB (LIS), MAB (HCWD workaround) All counties All counties *Schedule Subject to Change 31

32 Final Legacy Conversion Schedule The tentative schedule to completely convert all necessary records from the Legacy system before the end of the calendar year is as follows:. Release Targeted Major Release Contents System Outage # Deployment /25 10/26 Selective Conversion 5 PM Saturday to 5 AM Monday SDX and Defects Release N/A 11/1 11/2 Group 5 Hard Launch 7 PM Friday to 5 AM Monday Mini-Release (Account Transfer) /8 11/9 Selective Conversion 5 PM Saturday to 5 AM Monday MIC-L and Subprogram for CHIP USDA Forms Updates Defects Release N/A 11/15 11/16 Selective Conversion 7 PM Saturday to Noon Sunday N/A 11/22 11/23 SDX Case Conversion 9 PM Friday to 5 AM Monday N/A 11/29 11/30 No Outage Holiday Weekend /6 12/7 Selective Conversion Noon Saturday to 5 AM Monday SA w/ssi, LIS, HCWD Workaround and Defects Release COLA Updates N/A 12/13 12/14 SA Case Conversion and Mass Individual Conversion 9 PM Friday to 5 AM Monday Updates to turn off EIS /20-12/21 Contingency Weekend for Conversion 5 PM Saturday to 5 AM Monday Small Defect Release 12/27-12/28 No Outage 1/3 1/4 No Outage *Schedule Subject to Change 32