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Updated: 10:42 p.m. Tuesday, June 5, 2012 | Posted: 10:41 p.m. Tuesday, June 5, 2012
Columbus Bureau
COLUMBUS — Ohio is removing a hurdle for low-income pregnant women and children that prevents them from seeking and receiving medical treatment, Ohio Medicaid officials said Tuesday.
Beginning next week, pregnant women and children will be quickly screened to see if they’re likely eligible for Medicaid, and receive immediate and follow-up services while their full application makes its way through the system, which usually takes 45 days on average. The new policy will be tested at Nationwide Children’s Hospital in Columbus, MetroHealth System in Cleveland and the Community Action Committee of Pike County and then applied statewide beginning in January, state officials said.
Ohio Medicaid Director John McCarthy said the earlier that pregnant women receive prenatal care, the more likely that higher costs linked to premature babies will be avoided.
Dr. Kelly Kelleher, vice president for health services research at Nationwide Children’s Hospital, said roughly 10 percent of kids visiting the emergency room are likely eligible but not enrolled in Medicaid.
The hospital treats them, but the children often miss out on follow-up care with specialists and prescribed drugs because they aren’t enrolled, he said. Between 52 percent and 60 percent of children’s hospitals patients are covered by Ohio Medicaid, he said.
McCarthy said other states that have switched to a presumptive eligibility rule for pregnant women and children found that only 1 percent to 3 percent of clients turned out to not meet eligibility requirements.
Ohio Medicaid covers 2.2 million Ohioans, costs $20 billion in state and federal funds and includes 80,000 providers. Roughly 300,000 Dayton-area residents rely on it for health care.
Among the 2.2 million recipients are 1.2 million low-income children and 30,000 pregnant women. Kids and pregnant women are eligible if their household income is 200 percent or less of the federal poverty level. That equates to $46,100 per year for a family of four.
Greg Moody, director of the governor’s office on health care transformation, said later this week, Ohio will ask the federal government for permission to overhaul the Medicaid eligibility system for about 700,000 adults and to replace a 25-year-old computer system that frequently incorrectly denies eligibility.
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