May 22,2014

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Aaron Fobes/Julia Lawless (202) 224-4515

House, Senate Leaders Press Obama Administration On Backlog of Medicaid Applications Due to Challenges

In Letter to CMS Chief Tavenner, Leaders Question Whether CMS is Considering Punishing States for’s Technology Failures

WASHINGTON, DC – Republican leaders of the House Energy and Commerce Committee, Senate Finance Committee, and Senate Committee on Health, Education, Labor, and Pensions yesterday sent a letter to Marilyn Tavenner, Administrator for the Centers for Medicare and Medicaid Services, regarding the backlog of Medicaid applications in the states. Due to the technology failures of, many states have been forced to complete Medicaid applications by hand, creating a significant backlog.

In the letter to Administrator Tavenner, Chairman Fred Upton (R-MI), Ranking Member Orrin Hatch (R-UT), and Ranking Member Lamar Alexander (R-TN) reference an April 10, 2014, Senate Finance Committee hearing where Health and Human Services Secretary Kathleen Sebelius was asked about the growing backlog. Sebelius suggested that the administration is considering “ramping up the pressure on states and will look at potentially some administrative reductions in payment if people don’t pick up this pace …”

The congressional leaders write, “Secretary Sebelius’ response seems to suggest that CMS may be in the process of pursuing punitive payment actions against states in spite of – and perhaps even due to – their good-faith efforts to cope with information technology problems resulting from States should not be forced to pay for individuals who are ultimately not eligible for the program. We believe it would be inappropriate for CMS to reduce payments to states that may be experiencing a backlog of applications due to the troubles with”

The leaders press Administrator Tavenner: “Is CMS considering or pursuing administrative reductions in payments to states because of state backlogs in reviewing pending applications?”

They also request information regarding how CMS would implement those actions and who would be penalized. Finally, they ask: “When will CMS ensure that sends states accurate, complete data on applicants who are deemed eligible for Medicaid, in a manner that meets states’ needs?”

Read the complete letter online here.

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