Ohio seeks to overhaul Medicaid eligibility system

ANN SANNER Associated Press Published:

COLUMBUS, Ohio (AP) -- Ohio is closer to replacing an outdated computer system that's known for rejecting eligible people from the Medicaid program and accepting others who don't meet the criteria.

Officials said Wednesday the state will contract with Accenture LLC for a new system that will help determine who's eligible for programs across Ohio's health and human services agencies.

The move comes as the governor says he plans to expand the Medicaid program to cover more low-income people under President Barack Obama's health care law. Gov. John Kasich unveiled his decision on Medicaid expansion in his two-year state budget proposal on Monday.

The Kasich administration anticipates that almost 366,000 Ohioans will be eligible for coverage beginning in 2014 by expanding Medicaid, the health program for the poor that already provides care for one of every five residents in the state.

The state also is bracing for 230,000 eligible Ohioans to sign up for Medicaid once the federal law requires most people to have health insurance.

Kasich's proposed budget includes $230 million for the eligibility system upgrade, though the federal government would reimburse the state for most of the cost. The state's share of the bill is expected to be $26 million over the two-year budget.

The state's current eligibility system, known as CRIS-E, was launched in 1978. The administration says it's "so fragile and technically obsolete that it is no longer practical or cost effective to invest in enhancing the system."

The state estimates that 60 percent of CRIS-E's eligibility determinations for Medicaid are inaccurate and must be manually overridden to prevent applicants from being denied coverage or remove those who weren't eligible.

Officials say the move will make applicants' lives easier.

"This new system will allow more Ohioans to apply for services online, instead of waiting in line," said Greg Moody, director of the governor's Office of Health Transformation.

Ohio Medicaid Director John McCarthy said most who fill out the online applications would find out quickly whether they're eligible for the Medicaid program, without having to leave their home and go to a county office.

The state also wants to use the system to determine whether applicants are eligible for food or cash assistance programs.

"We're all working together to make it as seamless for a person as possible," McCarthy said.

The system will begin enrolling people in Medicaid by Jan. 1.