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Missouri officials say Medicaid applications are now processed within federal deadline

by Tessa Weinberg | September 15, 2022 at 4:00 a.m.

Missouri officials said Wednesday that Medicaid applications are now being processed within the federally mandated timeline of 45 days, a step toward bringing the state into compliance with a mitigation plan to address a backlog of applications.

Robert Knodell, the acting director of the Department of Social Services, broke the news to lawmakers Wednesday during a hearing of the House Subcommittee on Appropriations.

"I'm pleased to tell you today that that backlog is no more and we are now processing current Medicaid applications within the federal requirement of 45 days," Knodell told lawmakers, later adding: "Thankfully, now that backlog we are putting, as of this week, in the rearview mirror."

In an interview following the hearing, Knodell clarified there are applications older than 45 days, but in those instances, the department is still waiting on the applicant to provide additional information. "Nobody has an untouched Medicaid application older than 45 days, as of today," Knodell said.

The state has a Sept. 30 deadline to wrangle its backlog of applications, after the Centers for Medicare and Medicaid Services (CMS) took the unusual step of requiring a mitigation plan to get the state's processing time -- which averaged 115 days in June -- down to a maximum of 45 days. A spokesperson for CMS did not immediately respond to a request for comment.

In an interview, Kim Evans, the director of the Family Support Division, credited increased flexibility through the mitigation plan, like using information previously verified in other benefit programs, with helping process Medicaid applications as well as the work of department staff.

"They've really dug in, and just really they've given us overtime," Evans said. "They've just really worked very hard."

Evans told reporters late last month the average time it took to process a Medicaid application was 85-90 days, compared to the average of 106 days in July. A federal report released last month showed roughly four in every five Medicaid applications in Missouri took longer than 45 days to process at the beginning of this year -- eight times the national average.

Since July 1, 2021, the state has received more than 280,000 applications for Medicaid, Evans said, with around 12,000 applications still pending as of Wednesday. As of Sept. 9, 236,677 individuals have been enrolled into the expanded Medicaid group, according to the state's caseload counter.

Staffing shortages have been a persistent issue that has contributed to the lengthy backlog of applications, and officials said those challenges still exist.

"We're looking to fill positions, use creative strategies to recruit candidates, job fairs, workforce development pipelines, the usage of overtime when available within the confines of our system," Knodell said. "So it remains a challenge."

On average, Evans said around 30-33 employees are leaving each month.

As part of the mitigation plan with CMS, Evans said any applications received prior to Aug. 16 needed to be completed within the 45-day timeframe. Evans said the state has a few remaining pieces of pending information to complete before the state can submit to CMS it is compliant.

"They want us to be under 45 days as of September 30. We will be," Knodell said. "We're happy to be there today. And we will be there on Sept. 30 and moving forward."

The Missouri Independent,, is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.

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