Pennsylvania Medicaid Redesign Risk Assessment Error Assigned People With Behavioral Health Disorders To Wrong Plan Type

On December 23, 2014, the Pennsylvania Department of Human Services (DHS) notified stakeholders that it was aware of an error in its Medicaid risk assignment processes that assigned existing beneficiaries with behavioral health disorders to the new low-risk Private Coverage Option (PCO) plans, rather than the Medicaid Healthy Plus plan for medically frail beneficiaries. As a result, about 8,500 general assistance beneficiaries who had been in active mental health or addiction treatment were locked out of treatment due to differences in the PCO and Healthy Plus coverage.  DHS requested and received additional information from the Single County Drug . . .