Missouri pauses Medicaid cutoffs after reports of inaccurate address information

The Missouri Department of Social Services is pausing Medicaid cutoffs based on data showing recipients with out-of-state addresses after reports surfaced it was also wrongly flagging eligible residents for removal.

DSS acting director Robert Knodell told The Star Wednesday evening he has ordered a moratorium on the residency checks “through at least the end of February.” Since December the state has sent letters threatening the removal of benefits based on the residency checks to about 5,800 families, Knodell said.

The Star reported Monday that Missouri is relying on a third-party records database to find and drop Medicaid recipients who have moved out-of-state. But the database, LexisNexis, contains some erroneous or outdated information.

The situation has raised fears among health care advocates that eligible residents will lose coverage, and prompted lawmakers to ask questions of DSS.

The pause will allow the state to “investigate and better understand any errors or adverse consequences to Missouri Medicaid recipients as a result of the process our contract partner is undertaking,” Knodell told Rep. Peter Merideth, a St. Louis Democrat, in a message. “This pause will allow us time to analyze and make any necessary modifications to the process before we move forward.”

Legal aid and health advocacy groups have reported dozens of low-income clients asking for help contacting the state to provide proof that they never moved out-of-state. Many have run into hours of hold times trying to call DSS, where staff turnover rates are nearing 40% in the division that determines eligibility for social services.

The letters give the Medicaid recipients 10 days to respond before cutting off the benefits.

One Chesterfield woman, Heather Roberts, said she appeared to have been linked by LexisNexis to a city in Washington state where someone with the same name lives.

Roberts said she has had the same Missouri address for 11 years and has never even visited Washington. Roberts’ two children receive Medicaid and the state was preparing to remove them from the program before the Legal Services of Eastern Missouri helped her provide proof of residency.

Ruth Pera’s five children, who live in St. Louis, were linked to their grandmother’s home address in Ohio where Pera’s husband grew up. She said she spent five-and-a half-hours on hold with DSS before the call dropped her. At the pharmacy last week to refill an essential prescription for one of her daughters, two days after the state said it was terminating her children’s coverage, she saw the cost for a 30-day supply go up.

LexisNexis told The Star that the state could conduct “independent investigations” before terminating Medicaid recipients.

“Eligibility decisions are made by each state based on their own investigations,” a company spokesman said.

But the state appears to be relying only on the database. A Dec. 6 memo to staff from DSS Family Support Division director Kim Evans tells workers to begin benefits cutoffs based on the addresses LexisNexis flagged.

The residency checks were conducted as Missouri prepares to use other third-party services to check the income of nearly all its Medicaid recipients.

For the past two years, the state has been prohibited from cutting anyone off from coverage during the federal COVID emergency. Moving out of state is one of the few reasons DSS is still allowed to drop benefits during the emergency.

The emergency is set to end April 16, though it has been extended several times before. After that, the state will begin dropping those who now make too much to qualify for the program.

In preparing for the re-evaluation, DSS is hoping to avoid repeating issues that arose in 2019 when more than 90,000 children were removed from the Medicaid rolls. Part of the reason then, advocates said, was that many families never received renewal notices.

This story was originally published February 10, 2022 at 12:06 PM.