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Wolf administration to take first step in reorganizing Medicaid coverage for adults

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HARRISBURG, Pennsylvania — Gov. Tom Wolf's administration plans to begin transferring more than a million adult Medicaid enrollees into a single, new benefits program that it touts as a more efficient and effective way of providing health care for the poor, disabled and elderly.

The Department of Human Services will start moving more than 100,000 people Monday into the program, called Health Choices. It also will stop admitting new enrollees into plans that had been created by Wolf's predecessor, Tom Corbett, as part of Pennsylvania's expansion of Medicaid's income eligibility guidelines under the 2010 federal health care law.

Officials said no one will lose access to care with the shifts and no one needs to do anything until they are notified by the department.

"The message we've had for folks is 'If you have benefits from the department right now, until we contact you, you do not have to do anything,'" said the department's acting secretary, Ted Dallas. "Once we contact you, we'll help walk you through the process."

The department expects to finish the transfers by Sept. 30.

The moves are designed to undo Corbett's efforts to create three different benefits programs starting last Jan. 1, in conjunction with the expansion of Medicaid's guidelines. However, the federal government did not approve all of the benefits changes he had sought. Meanwhile, advocates for the poor complained that Corbett's plan was administratively burdensome, confusing to enrollees and unnecessarily stingy with benefits.

Some enrollees had struggled to get coverage for dialysis, mental health counseling or addiction treatment, they said. The benefits program designed by the Wolf administration includes coverage for dialysis and wider behavioral health networks, and is otherwise similar to the Medicaid program that existed before Jan. 1.

In some ways, the coverage is better, said Kristen Dama, a lawyer with Community Legal Services of Philadelphia, a public interest law center that helps the poor get access to services.

A limit on six prescriptions per enrollee that Corbett instituted in 2011 is going away because of protections in the 2010 health care law, Dama said.

Pennsylvania's Medicaid population hit a record high of 2.4 million in February, according to the latest state statistics. About 250,000 people have signed up under the expanded income eligibility guidelines that took effect Jan. 1, Dallas said.

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