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Action News helps local woman receive Medicaid after months of waiting

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Photo: Video by ktnv.com

Action News helps local woman receive Medicaid after months of waiting

By Stacey Gualandi. CREATED Apr 3, 2014

Las Vegas, NV (KTNV) -- We've been hearing from frustrated viewers for months about the problems they are having with Medicaid backlog delays.

On Thursday, Action News helped solve one local woman's problem.

Jo Don Garcia suffers from depression, needs a hip replacement and has an abscessed tooth as she waits for Medicaid to kick in, "I don't have the finances to get the medication or have a tooth pulled. One visit for a prescription at the hospital was over $800."

She qualified for Medicaid after applying on Nevada Health Link in December but was told to reapply in February, "Every two to three weeks I go to the welfare office and they say, 'You're pending; nothing we can do, you're pending.'"

Some days, Jo Don said she can't even get out of bed without the meds she needs. For now, she takes ibuprofen and prays. When asked how much longer she thinks she can go like this, she tears up. 

Thursday, Action News went along with Jo Don to the welfare office to get some answers, but she was told to come back the next morning and stand in line.

Right now, the state has a backlog of 60,000 applicants and that number is expected to keep rising. Staff has been added but delays continue.

When the manager of the welfare office heard that Jo Don was told to come back, he immediately took her into their offices. That's when they discovered what the problem was with her Medicaid application. 

When she reapplied, it erased her initial application from December, pushing her further back in line, most likely the state said, because of the heavy volume of Medicaid seekers. 

"I understand all of these problems, but I've been working for four months to get it and now I'm finally going to get it, but I had to call you," said Garcia.

Within an hour, Jo Don got approved, and will get her Medicaid card in a week or so. She said her first phone call will be to the dentist. 

"I bet there are other people here who could also use your help today and I hope you can help them too. I'm just so happy, thank you very much," said an elated Garcia.

Statement released from the Department of Health and Human Services:

"The Division of Welfare and Supportive Services believes every applicant is important. We are working as quickly as we can to help all eligible Nevadan’s obtain coverage. We know it can be frustrating to not know the status of an application and so this week applicants will receive a confirmation letter acknowledging receipt of the application and instruction that a case worker will contact them soon to obtain any additional information needed to make a determination of eligibility.

As a result of the Affordable Care Act, Medicaid application processing numbers are at record highs - prior to ACA the Welfare office processed an average of 550 application a day, and now we are processing an average of 1,200 per day, with a record high of 2,300 applications in a single day.    We have enrolled over 104,000 people in Medicaid in the last 6 months, which is an unprecedented number.

Timeliness regulations state Medicaid must be determined within 45 days, however, the agency goal is to process applications within 5-7 business days. In order to reach this goal, Welfare has implemented new business processes, hired more than 260 staff, and dedicated an entire office to register Medicaid applications. The increased staff and business practices are having an effect. To compare, in July 2013, 12% of applications were processed within 5 days, and in February 2014, nearly a quarter were processed within 5 days."

Stacey Gualandi

Stacey Gualandi

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Stacey Gualandi joined the Action News team as a general assignment reporter in July 2013.