Dental Care Provider Halts Services At Kansas Nursing Homes Amid Medicaid Backlog

Jan 24, 2017

Editor’s note: An update to this story was posted at 5 p.m. Jan. 26.

About 350 elderly and disabled Kansans are suddenly without dental care after an Oklahoma City company informed nursing homes that it was suspending services for Kansas residents whose Medicaid applications are pending.

The company, Sterling Dental, sends dentists to nursing homes in Oklahoma, Missouri and Kansas for on-site care.

But ongoing problems with Kansas’ Medicaid application process have left some residents waiting almost a year for coverage, and Sterling has decided it can no longer wait to be paid.

Cindy Luxem heads the Kansas Health Care Association, a nursing home advocacy group in Kansas. She said she heard about Sterling’s decision from another advocacy group, LeadingAge Kansas, and was frustrated that the backlog of Medicaid applications had caused another problem.

“This kind of stuff just can’t be happening,” Luxem said. “This isn’t how Kansas operates and this isn’t how we want our folks in Kansas to be taken care of.”

Luxem and LeadingAge officials have informed the Kansas Department of Health and Environment about the problem.

The nursing home advocates learned of Sterling’s decision just hours after Rep. Dan Hawkins questioned KDHE Secretary Susan Mosier about the backlog during a hearing Monday.

Hawkins, a Wichita Republican who chairs the House Health and Human Services Committee, recalled during the hearing that Mosier had assured him during an August meeting that the backlog would be gone by the end of September.

Mosier said Monday that the backlog had been reduced to about 2,000 applications from a high of about 11,000.

Hawkins responded by saying that to the nursing homes involved, it remained a problem. In a phone interview Tuesday, he said the news about Sterling Dental reinforced that.

Hawkins said his comments were motivated not by a desire to criticize KDHE and the Brownback administration but by “the desire to have a (Medicaid) program that works well.”

“I really want to get to the bottom of this and get this thing fixed,” Hawkins said.

The Medicaid backlog began with the rocky rollout of a new computer system for processing applications in the summer of 2015. It grew substantially the following January, when a Brownback executive order funneled all Medicaid applications through a single clearinghouse in Topeka in the middle of the Affordable Care Act open enrollment period.

By the spring of 2016, thousands of applications had been pending longer than the 45-day federal limit and the Centers for Medicare and Medicaid Services began requesting updates on the backlogged applications every two weeks.

The state hired more staff and shifted other personnel to help with the processing. State officials say they’re now caught up except for more complex applications for long-term care of elderly and disabled Kansans that used to be processed by the Kansas Department for Children and Families.

Mosier said after Monday’s hearing that the state will soon provide webinar training for nursing home staff members who help residents fill out long-term care applications. KDHE is also planning to assign each application to specific teams, similar to the way DCF did, rather than assigning customer service calls to random clearinghouse workers.

Andy Marso is a reporter for KCUR’s Kansas News Service, a collaboration of KCUR, Kansas Public Radio and KMUW covering health, education and politics in Kansas. You can reach him on Twitter @andymarso. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to kcur.org.