Washington, D.C., Mayor Fenty Proposes Measures to Close Eligibility Loopholes in Healthcare Alliance

Washington, D.C., Mayor Adrian Fenty and district Department of Health interim Director Carlos Cano on Wednesday released a plan to ensure that only qualified residents receive coverage under the district's Healthcare Alliance program, the Washington Post reports. The Alliance is intended to provide coverage for district residents with incomes up to 200% of the federal poverty level who do not qualify for Medicaid. However, an audit of the program from June 2006 to mid-November 2007 found that a lack of eligibility verification by the district Income Maintenance Administration meant applicants could "misrepresent facts to obtain eligibility and the misrepresentation may go undetected." The audit also found many cases in which multiple payments were made to the same person or payments were made after an individual's eligibility had expired.

Fenty and Cano's plan would provide additional staff training on how to screen and enroll beneficiaries; additional community education on program rules; and prompt transfers of seniors to Medicare and Medicaid, among other measures (Levine, Washington Post, 2/28). The audit also recommended making further inquiries into applicants' citizenship status to ensure they are not eligible for other programs; improving the investigative arm of IMA; and investigating addresses where an unusually high number of applicants reside (Washington Times, 2/28).

Fenty said, "The District has made great strides in reducing barriers for enrollment for these populations and will continue to maintain our promise to provide health care services to all district residents" (Washington Post, 2/28).

The mayor's plan is available online (.pdf). The audit report also is available online (.pdf).