A snapshot of eligibility trends documentation requirements, a program of the Georgia Department of Community Health [Feb. 2007]

A Program Of The Georgia Department Of Community Health
A SNAPSHOT OF
Eligibility Trends
Documentation Requirements

Overview
Concern has been raised about the effects of recent changes in documentation requirements and their affects on enrollment of children in Medicaid and PeachCare for KidsTM (PCK). In January 2006, the State of Georgia began requiring that Medicaid applicants and recipients verify their income and American citizenship. Georgia received further guidance as a result of The Deficit Reduction Act of 2005 (DRA) regarding the documentary evidence required before Medicaid eligibility is granted or renewed. This new guidance became effective July 1, 2006. The DRA provisions require that a person submit evidence of both citizenship and identity.
The DRA specifies certain forms of acceptable evidence of citizenship and identity, and provides for the use of additional forms of documentation as established by federal regulations, when appropriate. The following reflects actual data regarding those policy changes.

Trends in Eligibility Determinations for Family Medicaid
The following graph depicts the trends in eligibility determinations for Family Medicaid, which include Low Income Medicaid and Right from the Start Medicaid. The graph includes all members in the group, adults and children, through November 2006.

60,000 50,000 40,000 30,000 20,000 10,000
0

Fam ily M edicaid

Total Redeterm ine Denials
Redeterm ine Docum ent Denials
Total A pplicant Denials
Applicant Docum ent Denials

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Enrollment of Children in Family Medicaid and PeachCare for KidsTM The next graph depicts actual enrolment of children in Family Medicaid and PCK.

C u m u lative C h ild C o verag e
1,200,000 1,000,000
800,000 600,000 400,000 200,000
0 Jan-04 May-04 Sep-04 Jan-05 May-05 Sep-05 Jan-06 May-06 Sep-06

P eachCare RSM Child LIM Child

2 Peachtree Street, Atlanta, Ga 30303 w www.dch.georgia.gov

February 2007