CHARLESTON, W.Va. -- For the second time in a month, a national organization has sharply criticized West Virginia's revamped Medicaid program, saying thousands of low-income children and adults are "falling through the cracks" and losing much-needed health care services.

Washington, D.C.-based Families USA said the state failed to educate Medicaid recipients about the program's changes, leaving many people confused, according to a report released Wednesday.

The organization asserts that the redesigned Medicaid plan isn't improving health care for West Virginians as intended because of "procedural hurdles and flawed program design."

"This is a program that's inherently flawed," said Rachel Klein, deputy director of heath policy at Families USA. "It's taking away people's access to critical health care services."

Earlier Wednesday, state Department of Health and Human Resources Secretary Martha Walker called on Families USA to postpone the report's release, saying the findings were biased and "unfairly critical."

Walker said a Families USA official told a state Medicaid office administrator that the organization was philosophically opposed to West Virginia's redesigned program, which requires Medicaid recipients to sign personal responsibility agreements to improve their health in exchange for expanded benefits.

Walker said her office requested to review the report for accuracy prior to publication, but Families USA refused. The organization shared the report with Medicaid redesign critics in West Virginia, Walker said.

"They are interested in nothing more than preserving the status quo," Walker said. "They pander to the poor and don't respect their ability to make a choice because of their financial status."

The state's new Medicaid approach -- the first of its kind in the country -- includes incentives to entice low-income people to take steps to improve their health

By last month, only 7 percent of adults and 8 percent of children receiving Medicaid across the state -- about 12,000 people -- had enrolled in the revamped program's expanded benefits package, called the "enhanced plan," which includes services such as cardiac rehabilitation and smoking cessation classes.

Most Medicaid recipients are winding up -- some by choice, others by default -- with the state's scaled-back "basic" package that has fewer benefits than traditional Medicaid. The basic plan limits people to four prescriptions a month -- though some life-saving drugs are exempt.

Klein said the state Medicaid office didn't explain the importance of signing up for the expanded plan in materials sent to Medicaid recipients.

CHARLESTON, W.Va. -- For the second time in a month, a national organization has sharply criticized West Virginia's revamped Medicaid program, saying thousands of low-income children and adults are "falling through the cracks" and losing much-needed health care services.

Washington, D.C.-based Families USA said the state failed to educate Medicaid recipients about the program's changes, leaving many people confused, according to a report released Wednesday.

The organization asserts that the redesigned Medicaid plan isn't improving health care for West Virginians as intended because of "procedural hurdles and flawed program design."

"This is a program that's inherently flawed," said Rachel Klein, deputy director of heath policy at Families USA. "It's taking away people's access to critical health care services."

Earlier Wednesday, state Department of Health and Human Resources Secretary Martha Walker called on Families USA to postpone the report's release, saying the findings were biased and "unfairly critical."

Walker said a Families USA official told a state Medicaid office administrator that the organization was philosophically opposed to West Virginia's redesigned program, which requires Medicaid recipients to sign personal responsibility agreements to improve their health in exchange for expanded benefits.

Walker said her office requested to review the report for accuracy prior to publication, but Families USA refused. The organization shared the report with Medicaid redesign critics in West Virginia, Walker said.

"They are interested in nothing more than preserving the status quo," Walker said. "They pander to the poor and don't respect their ability to make a choice because of their financial status."

The state's new Medicaid approach -- the first of its kind in the country -- includes incentives to entice low-income people to take steps to improve their health

By last month, only 7 percent of adults and 8 percent of children receiving Medicaid across the state -- about 12,000 people -- had enrolled in the revamped program's expanded benefits package, called the "enhanced plan," which includes services such as cardiac rehabilitation and smoking cessation classes.

Most Medicaid recipients are winding up -- some by choice, others by default -- with the state's scaled-back "basic" package that has fewer benefits than traditional Medicaid. The basic plan limits people to four prescriptions a month -- though some life-saving drugs are exempt.

Klein said the state Medicaid office didn't explain the importance of signing up for the expanded plan in materials sent to Medicaid recipients.

"The way they're going about implementing this is causing problems," Klein said. "People aren't getting the information they need to get into the enhanced benefit program."

Medicaid recipients enrolled in the enhanced plan must visit a doctor and sign an agreement, promising to keep appointments and stay out of the hospital emergency room.

The Families USA report said the agreement includes "unrealistic demands" that are a burden on most low-income parents who might be unable to take time off from work or find a ride to a doctor's office.

"Penalizing participants for certain actions, like missing a doctor's appointment, is not likely to condition their behavior and make them healthier individuals," the report states.

Families USA also criticized the state for expanding the redesigned Medicaid program from three pilot counties -- Lincoln, Upshur and Clay -- last year without evaluating the changes.

The report scolds the state for limiting mental health services for children under the basic plan. The state also has stopped paying for "crisis" mental health care, according to Families USA.

State Medicaid officials responded that children get unlimited visits to psychiatrists and psychologists and continue to receive all medically necessary services.

Last month, Georgetown University's Center for Children and Families assailed West Virginia's Medicaid changes, saying the new program was failing the state's children.

Though the revamped program -- called Mountain Health Choices -- has sparked criticism from national groups, few Medicaid recipients have complained about the changes, Walker said.

The program isn't expected to be fully up and running until next year.

"It needs a chance to work and be successful," Walker said. "Short-sighted advocates want to forever debate policy that doesn't work. They are poisoning the perceptions of this program, a program that's eventually going to positively change health care attitudes in the state."

Reach Eric Eyre at erice...@wvgazette.com or 348-4869.