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[MM Curator Summary]: In one example, one family got 48 letters with 460 pages of information in 2 months from the Medicaid agency.
A state audit released Monday showed that communications from Medicaid to its members is not always accurate, complete or understandable.
The report from the the Office of the State Auditor says that information needs to be more accurate, understandable, informative and clear.
The audit found that of 80 sampled letters sent to Medicaid members, 72 had one or more problems, including duplicated information, contradictory and confusing messages, unclear guidance and complicated sentences and word choice, according to a news release from the auditor’s office.
In January and February this year, one family got 48 Medicaid letters with 460 pages. In the same two-month time period, a second family got a 57-page Medicaid letter that repeated the same message 63 times, the audit said.
Letters also contained inaccuracies, such as deadline dates that didn’t comply with state Medicaid requirements, inconsistent response timeframes for the same type of information requests and Spanish-language translations that were unclear.
“Unclear, inaccurate, and incomplete correspondence can create frustration and confusion for Medicaid members and ultimately lead to barriers with accessing health care, wasted resources, and potential legal issues for the Department,” Kate Shiroff, the audit manager, said in the news release.
As of July, the Department of Health Care Policy and Financing reported about 1.7 million Coloradoans enrolled in Medicaid, which is a federal-state program providing healthcare coverage and services to low-income families.
Medicaid is administered federally be the Centers for Medicaid and Medicare Services under Title XIX of the Federal Social Security Act and, in Colorado, by the Department of Health Care Policy and Financing.
Colorado’s Medicaid program is called Health First Colorado.
In January and February, the Department of Health Care Policy and Financing sent more than 400,000 letters to members each month out of the Colorado Benefits Management System related to eligibility for Medicaid programs. The department’s vendors also sent over 24,000 prior authorization approval and denial letters to members each month.
Many of the same issues found in the 2023 audit were also found in work conducted in 2016 by a communications contractor with the Department of Health Care Policy and Financing. Many of them were found again by an audit contractor in 2020.
“These problems persist because the department has not fully implemented previous recommendations to change its monitoring functions, work processes, guidance to workers, and system design,” the news release says.
The full audit is available on the OSA website at www.colorado.gov/auditor.