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Thousands of Medicaid appeals, no requests to group home housing fund

More than 2,500 people have appealed their loss of Medicaid support for personal care services, according to the state Department of Health and Human Services.

Meanwhile, no group home has requested money to compensate for the loss of Medicaid reimbursements for personal care, the DHHS said.

Medicaid rules that took hold on Jan. 1 made it harder for people living in adult care homes and group homes for the mentally disabled to qualify for Medicaid money for help bathing, walking, and eating. DHHS expects 9,000 people to appeal, or just about everyone who was told they no longer qualify for Medicaid personal care, said department spokesman Brad Deen.

Before she left office, Gov. Bev Perdue allowed $1 million in rental assistance to be used by group homes this month to compensate for the loss of Medicaid. She was responding to pleas from group home residents and advocacy groups who worried residents would be kicked out of residences. The legislature set up a separate fund $39.7 million fund for adult care homes to tap through June 30.

But it appears that the appeals option is more appealing. So popular is the appeals route that DHHS loaned workers to the Office of Administrative Hearings to help get all the appeals logged in.

Medicaid appeals cases are supposed to be resolved within 90 days, so depending on how quickly the state Office of Administrative Hearings can move through the stack, people who appeal may have their Medicaid services extended by three months. Or more. The federal government is aware of the crush of appeals, said DHHS spokesman Brad Deen, and may not hold the state to the 90-day deadline.


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