Medicaid

Kansas officials continue to whittle away at a backlog of Medicaid applications that developed over the past year.

But as they do so, people with expertise in Medicaid eligibility say they’re seeing an increase in incorrect denials.

Ozarks Community Hospital

A new study by Georgetown University's Health Policy Institute finds stark differences between states that have expanded Medicaid eligibility under the Affordable Care Act and those — like Kansas and Missouri — that haven’t.

Andy Marso / Heartland Health Monitor

Kansas tax collections for May fell short of projections by about $74 million, and legislators said Wednesday they fear that will mean more cuts to Medicaid.

The May shortfall comes despite the state’s revenue estimating group revising projections downward for the third consecutive time about six weeks ago.

It wipes out the meager savings Gov. Sam Brownback created when he made cuts two weeks ago after the Legislature sent him a budget that didn’t balance.

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Kansas health care providers will urge federal officials to reject Gov. Sam Brownback’s proposed Medicaid cuts and may challenge them in court.

The recently announced cuts would reduce state expenditures for KanCare, the state’s privatized Medicaid program, by $56.3 million and trigger a loss of approximately $72.3 million in federal funds. Combined, the managed care organizations that administer $3 billion KanCare program and the health care and service providers they have contracts with would be forced to absorb more than $128 million in cuts.

Bryan Thompson / Heartland Health Monitor

State officials on Thursday wrapped up a series of public forums on the pending renewal of KanCare, the state’s privatized Medicaid program.

Federal approval for the five-year demonstration project expires at the end of 2017, and the Kansas Department of Health and Environment plans to apply for reauthorization by the end of this year.

Forum organizers were looking for ideas about coordination of care, value-based payment systems and waiver integration.

Andy Marso / Heartland Health Monitor

A proposal to reimburse some KanCare providers at a higher level based on patient outcomes drew skepticism from a crowd of hundreds who gathered Tuesday afternoon in a Topeka hotel ballroom.

Tuesday’s public meeting was the first in a series that state officials are hosting as they prepare to renew their federal application for KanCare, the state’s $3 billion managed care program that privatized all Medicaid services under three insurance companies in 2013.

Similar gatherings are scheduled Wednesday in Kansas City, Kan., and Wichita and Thursday in Pittsburg and Hays.

File photo / Heartland Health Monitor

This story was updated at 8:30 p.m.

Gov. Sam Brownback trimmed more than $56 million from Medicaid in Kansas as part of larger budget cuts announced Wednesday, raising concerns that health care providers may decide not to take unprofitable patients.

About $38.2 million of the $56.4 million in budget cuts comes from reducing reimbursements by 4 percent for providers who treat patients covered by KanCare, the state’s privatized Medicaid program launched in 2013. The remaining $18.2 million comes from cuts in other areas of the Medicaid program.

State officials have scheduled five meetings to gather public comment on KanCare in advance of renewing contracts to administer the state’s privatized Medicaid program.

The contracts currently held by UnitedHealthcare, Amerigroup and Sunflower State Health Plan (a subsidiary of Centene) expire in 2018. Those private insurance companies serve as managed care organizations that operate KanCare.

Susan Mosier, secretary of the Kansas Department of Health and Environment, said her agency wants to hear from the public on what to include in the next contracts.

Susie Fagan / Heartland Health Monitor

After another legislative session with no action on Medicaid expansion, advocates in Kansas are turning their attention to the upcoming state elections and urging voters to become more vocal on the issue.

A Monday rally in a Statehouse hearing room drew a standing-room-only crowd. It was better-attended than other similar rallies in the four years since the U.S. Supreme Court ruled that states have discretion over whether they expand Medicaid under the Affordable Care Act, commonly called “Obamacare.”

Matt Hodapp / Heartland Health Monitor

The two Planned Parenthood organizations in Kansas and Missouri wasted little time challenging Kansas’ termination of their Medicaid funding.

Just a day after the Kansas Department of Health and Environment notified them of its decision to cut off their Medicaid payments,  Planned Parenthood of Kansas and Mid-Missouri and Planned Parenthood of St. Louis Region sued the head of the agency, Susan Mosier.

Andy Marso / Heartland Health Monitor

Gov. Sam Brownback’s administration will not fight a legislative directive to postpone the integration of Medicaid waiver services for Kansans with disabilities, according to an email sent by an administration official.

The Legislature passed a budget early Monday that included a provision prohibiting spending in the next fiscal year on any waiver integration plan to be implemented before July 2018.

Earlier this year, 69-year-old Aneita McCloskey needed her two front teeth filed down and capped.

“They were kind of worn down and they were also getting little tears and cavities,” she recalls.

Without dental insurance, McCloskey is on the hook for the full $2,400 cost of the procedure. She was given 18 months to pay it before she gets charged interest. That’ll be hard to do on her fixed income.

In years past she would have had to wait to see the dentist again until she could afford it.


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The Kansas Legislature added several patient protection measures to a bill allowing “step therapy” for Medicaid drugs before passing the legislation early Monday morning.

Advocates for Kansans with mental illness and other conditions were pleased with the changes but remain concerned about the possible effects of the underlying bill on vulnerable patients.

Step therapy requires Medicaid patients to try the least expensive medications for treating their ailments first. If those fail, they can then “step up” to a more expensive alternative.

Susie Fagan / Heartland Health Monitor

Legislative budget negotiators have agreed to insert a provision in the state budget preventing Gov. Sam Brownback’s administration from consolidating Medicaid support services for Kansans with various disabilities.

The Medicaid waiver integration plan has been a point of contention between the administration and a legislative subcommittee appointed to study the issue. The subcommittee issued a report recommending the integration be delayed a year to Jan. 1, 2018, and requesting more details on the plan.

File photo / Heartland Health Monitor

Federal officials have reversed position on a long-standing ban on paying for some inpatient psychiatric care, giving a possible boost to Kansas crisis centers.

The Centers for Medicare and Medicaid Services released a proposed rule Monday that will place new requirements on managed care organizations administering Medicaid, such as the three insurance companies that operate KanCare, the state’s privatized $3 billion program.

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Members of the Legislative Post Audit Committee again declined Tuesday to request an investigation into whether the Kansas Department for Children and Families has placed children in risky situations because of a preference for heterosexual foster parents.

Rep. Jim Ward, a Democrat from Wichita, first requested the audit in December after reports surfaced of DCF removing a baby from the home of a lesbian couple in Wichita and placing it with a heterosexual Topeka couple who subsequently were charged with child abuse.

Andy Marso / Heartland Health Monitor

Two employees of Larned State Hospital made rare public comments Monday about difficult working conditions at the mental health facility.

Kyle Nuckolls and Lynette Lewis described for a legislative committee the toll that mandatory overtime and limited time between shifts is taking on workers at the short-staffed facility and their families.

“I’ve never seen it this bad,” said Lewis, a pharmacy technician who has worked at Larned for 18 years.

Susie Fagan / Heartland Health Monitor

Representatives of 15 groups that advocate for Kansas Medicaid populations sent a letter to state leaders this week urging them to eliminate a Medicaid application backlog that has left thousands of Kansans awaiting coverage.

The groups have formed a coalition called the KanCare Advocates Network. They represent children, pregnant women and Kansans who are elderly or disabled.

Kansans from those populations have been waiting months, in some cases, for their Medicaid applications to process.

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Editor’s note: A backlog of Medicaid applications has caused financial strain for nursing homes and put thousands of Kansans at risk for loss of medical care. State officials trace the beginnings of the backlog to a computer system switch.

Matt Hodapp / KCUR 89.3

A Democratic leader in the Missouri House is praising the version of the state budget approved by the Senate last week, especially its restoration of most of the $8.7 million cut from the University of Missouri system in the House version.

Rep. Gail McCann Beatty (D-Kansas City) joined KCUR's Statehosue Blend podcast and told host Brian Ellison that she thinks the Senate's version of the $27.2 billion budget is more fair than the one passed by her House colleagues weeks before

Courtesy Bill Stovall

A statewide registry is in the works to make it easier for Medicaid patients to find qualified, reliable personal care workers.

That’s good news for Bill Stovall of Topeka and others like him who help direct care for their family members.

Stovall has a long list of complaints against personal care workers who have cared for his sister in recent years, including punctuality problems and a lack of training.

Matt Hodapp / KCUR 89.3

Missouri Rep. John Rizzo (D-Kansas City) joined KCUR 89.3's Statehouse Blend podcast to discuss what to expect as the legislature returns from spring break this week.

This is an excerpt from Statehouse Blend. You can listen to the full episode here, or by subscribing on iTunes.

Guests:

Matt Hodapp / KCUR 89.3

Missouri Rep. John Rizzo (D-Kansas City) said the General Assembly may have a difficult time making progress on significant legislation this session.

File photo / Heartland Health Monitor

Nursing home representatives breathed a sigh of relief Friday as the state announced a program to help them get Medicaid money for some residents whose applications are stuck in processing delays.

The delays — traced back to a computer system switch in July and administrative changes in January — have led to thousands in unpaid bills for facilities and prevented some frail Kansans from finding a nursing home bed.

Mercy Hospital Independence

A new organization is forming to strengthen the lobbying effort for Medicaid expansion in Kansas.

The Alliance for a Healthy Kansas will focus on passing an expansion bill in 2017, not in the waning days of the current session, according to Billie Hall, the chief executive of the Topeka-based Sunflower Foundation.

In an email sent Wednesday to approximately 2,000 people registered to receive updates from the foundation, Hall urged individuals and organizations from across the state to join the alliance so that it can mount a strong lobbying effort next year.

Creative Commons-Pixabay

Kansas lawmakers are close to finishing their work on a bill they hope will motivate doctors and dentists to provide more charity care.

Though the measure enjoys bipartisan support, its most ardent supporters are Republican legislators who are opposed to Medicaid expansion and need something that shows voters they’re willing to help poor Kansans gain access to health care.

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Federal officials are concerned about a growing backlog of Kansas Medicaid applications and have asked state leaders to provide regular updates about what they're doing to fix the problem.

James Scott, associate regional administrator for the federal Centers for Medicare and Medicaid Services sent a letter to Kansas Department of Health and Environment officials Feb 17, citing concerns about “recent reports" of the Medicaid application backlog in the state of Kansas.”

Scott asked KDHE to submit within 14 days a plan to correct the backlog.

Public Opinion Strategies

Poll results released Monday by the Kansas Hospital Association show a majority of Kansans continue to favor expanding Medicaid to cover more low-income adults.

The statewide poll conducted in mid-February found that 62 percent of Kansas voters supported expanding KanCare, the state’s privatized Medicaid program, to cover approximately 150,000 non-disabled adults earning up to 138 percent of the federal poverty level, or $16,243 for an individual and $33,465 for a family of four in 2015.

Andy Marso / Heartland Health Monitor

Judy Kregar is not a member of the Rotary Club in nearby Greensburg, but she decided to go when she heard Gov. Sam Brownback would be at the club’s recent meeting.

Kregar, the administrator of a small nursing home in nearby Bucklin, wanted to tell Brownback in person about the struggles some of her residents are having getting their Medicaid applications and annual renewals processed.

Susie Fagan / Heartland Health Monitor

Proponents of expanding Medicaid eligibility in Kansas need to change tactics and prepare for a long process, a health policy researcher told them Wednesday.

Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University in northern Virginia, said Kansans who currently oppose expanding Medicaid aren’t likely to be persuaded by statistics from “eggheads” like himself.

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