Medicaid

Courtesy Missouri Hospital Association

Medicaid expansion probably wasn’t in the cards in Missouri before Tuesday’s elections. And now that the Missouri legislature is expected to lurch even further to the right, it appears to be dead on arrival.

Perhaps somewhat surprisingly, however, proponents of expanding Medicaid eligibility haven’t given up hope that health coverage can be extended to thousands of Missourians currently going without.

File photo

Medicaid expansion advocates in Kansas say they’ll move forward with legislation despite national election results that signal a repeal of Obamacare.

But they are a lot less optimistic about their chances than they were before last week.

Click here to read about a Kansas City family's growing anxiety about Obamacare's repeal

For three months, 32-year-old Tara Hegger has lived in the intensive care unit at Mercy Hospital.

She passes the time listening to music, visiting with family members and watching TV, mostly comedies. They keep her mind off of a painful decision that inches closer every day.

“The social worker came to me and basically told me I had to leave, because my days ran out," Hegger said, pausing between the pumps of oxygen provided by a ventilator next to her. "I had to make a choice.”

Like other Missouri patients in her situation, she will have to leave the state to find a nursing home that accepts her insurance — a dilemma tied to the state's low Medicaid reimbursement rate for long term care.

A Kansas City, Kansas, home health care agency and its owner will pay $1.8 million to settle allegations that it paid kickbacks in return for referrals of Medicaid patients to the agency.

Best Choice Home Health Care Agency Inc. and its owner, Reginald B. King, will pay the federal government just over $1 million and the state of Kansas $788,220 to resolve the case, according to court documents unsealed on Monday.

Aaron Pellish / KCUR 89.3

It's been 40 years since Missouri voters have sent two Democrats to represent them in the U.S. Senate. If Jason Kander has his way, that will soon change.

A recent poll released by Monmouth University indicates Kander, the state's Secretary of State since 2013, has narrowed incumbent Roy Blunt's lead to within the margin of error.

Aaron Pellish / KCUR 89.3

Missouri hasn't had two Democratic U.S. Senators in 40 years, but Jason Kander is looking to change that. Today, we speak with the current Missouri Secretary of State about his run to defeat incumbent Sen. Roy Blunt in what has become a very competitive race.

Alex Smith / Heartland Health Monitor

At his apartment in Olathe, Kansas, 42-year-old Nick Fugate catches up on washing dishes and remembers the 22 years he spent doing it at a local hotel, trying to stay on top of a never-ending-stream of plates, glasses and silverware.

Nick recalls minor annoyances like the long days, the hot kitchen and his fingers pruning in the water. It could be tedious, but he says he didn’t really mind.

“Just as long as I got the job done, it was fine,” Nick says.

Bryan Thompson / Heartland Health Monitor

A working group charged with finding “Kansas solutions” to the problems surrounding health care delivery in rural Kansas still hasn’t settled on a direction. 

Near the end of Rural Health Working Group’s meeting Thursday in Salina, Rep. Jim Kelly of Independence asked the other members to at least consider what he called “the 800-pound gorilla” in the room: Medicaid expansion. Kelly thinks expanding eligibility for Medicaid might help other communities avoid the hospital closure that occurred in Independence. 

Megan Hart / Heartland Health Monitor

Several Kansans are scheduled to meet Tuesday with federal officials and counterparts from across the country to discuss issues related to the privatization of state Medicaid programs.

Courtesy John Fales

The president of the Kansas Dental Association said he has stopped taking patients from two of the state’s three KanCare insurance companies because of a 4 percent Medicaid reimbursement cut initiated by Gov. Sam Brownback’s administration.

John Fales, a pediatric dentist from Olathe, said Scion — the dental benefits manager for United HealthCare and Amerigroup — has told him it will implement the cut before it is approved by the federal Centers for Medicare and Medicaid Services.

Jim McLean / Heartland Health Monitor

Legislative auditors said Wednesday they can’t confirm that the Medicaid application backlog numbers state officials have reported are correct.

Applications have been backlogged for about a year following the rocky rollout of a new computer system, an administrative decision that funneled all applications through a single state agency and a larger-than-expected influx of applications during the Affordable Care Act open enrollment period.

Stormont Vail Health of Topeka is closing two regional clinics because of financial pressures created by recent cuts in Medicaid reimbursements and the decision by state leaders not to expand the health care program.

Stormont will close Cotton O’Neil clinics in Lyndon and Alma, according to a news release issued Thursday. The Lyndon clinic will close Dec. 31. The clinic in Alma will close Jan. 31, 2017.

Brad Nading

After a series of hits to their budgets, community mental health centers in Kansas are adjusting through cutbacks, changes in services or a combination of the two.

In Topeka, Valeo Behavioral Health Care plans to limit sessions for uninsured patients. Valeo provided about $2 million in charitable care last year but can’t offer that much this year because of cuts to Medicaid and other revenue streams, CEO Bill Persinger says.

Health Insurance Coverage in the United States: 2015

The uninsured rates in Kansas and Missouri continue to drop.

But they’re declining faster in states that have expanded Medicaid, the health insurance program for low-income families, seniors and people with disabilities.

New data out Tuesday from the U.S. Census Bureau estimates that Kansas’ uninsured rate dropped to 9.1 percent in 2015, down from 10.2 percent the year before and 12.3 percent in 2013.

Jim McLean / KHI News Service

A large section of what used to be Mercy Hospital in Independence, Kansas, has been torn down in the year since it closed.

On a hot August day, a bulldozer is prepping the lot where it once stood for construction of a new city garage.

Andy Taylor, the editor of the weekly Montgomery County Chronicle, says many residents of the community of about 10,000 still aren’t sure exactly what happened. But he says they believe city and state officials could and should have done more to save the hospital.

Stefani Fontana / KCUR 89.3

Former KCUR intern Stefani Fontana, now a fourth-year medical student at the University of Kansas School of Medicine, spent last summer doing a clinical rotation in western Kansas. We asked her to keep a journal of her experiences. We’ve edited out actual names of people and places to protect privacy, but otherwise present these condensed journals largely as she wrote them. 

Part 1 of 4: Go west, young doctor

Courtesy Nimrod Chapel Jr.

An attorney for the so-called “Medicaid 23” says his clients will appeal their convictions on trespassing charges, even though they face no jail time.

A Cole County, Missouri, jury on Wednesday acquitted 22 clergy members of obstructing government operations but found them guilty of trespassing when they refused to leave the Missouri Senate gallery during a protest in May 2014. The case of the 23rd defendant will be decided later.

It's a split decision in the trial of the so-called "Medicaid 23," a group of religious leaders who staged a protest in the Missouri Senate more than two years ago over lawmakers' refusal to expand Medicaid.

Twenty-two members of the group were found guilty of trespassing for not leaving the Senate gallery when ordered to do so by Capitol police. But they were found not guilty of obstructing the operations of the Senate. The case of one other member will be decided later.

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The waiting list for Medicaid services for Kansans with physical disabilities has dropped by more than 1,700 since last year but hasn’t budged for those with intellectual or developmental disabilities.

In July, 3,450 Kansans with intellectual or developmental disabilities were waiting for home and community-based services provided through Medicaid, as were 10 Kansans with physical disabilities.

Hewlett Packard Enterprises

Computer giant Hewlett Packard Enterprises has entered into a $215 million contract with the state of Kansas to upgrade a Medicaid computer system that tracks patient claims payments to providers.

Marshall Griffin / St. Louis Public Radio

The trial of 23 people who protested Missouri’s failure to expand Medicaid began today in Jefferson City with jury selection.

The so-called Medicaid 23 defendants include many notable Kansas City clergy members, among them Sam Mann, Wallace Hartsfield and Vernon P. Howard Jr. They are accused of trespassing and obstructing government operations, both misdemeanors.

The unusual mass trial stems from protests the defendants staged in May 2014. They were arrested after refusing to leave the Senate gallery, where they were chanting and singing.

Andy Marso / Heartland Health Monitor

John Fasbinder’s dental office was busy on a recent Tuesday.

Three employees helped in the reception area, answering phones and clicking away at computers. Hygienists tended to patients in three dental chairs in the main clinic. Fasbinder and his associate, Seth Cohen, flitted among those patients and others in private rooms set up for more intensive work.

Most days are like this for Fasbinder. At his Prairie Village office, he takes patients on Medicaid — no matter how old they are, what part of Kansas they come from or how difficult they are to treat.

Andy Marso / Heartland Health Monitor

The leaders of some Kansas community mental health centers say they are having trouble getting paid for some Medicaid services they believe their clients need.

Brenda Mills, CEO of Family Service and Guidance Center, a Topeka-based community mental health center that serves children, spoke Thursday at a meeting of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.

Courtesy Kansas Department for Aging and Disability Services

Editor’s note: Heartland Health Monitor partner KHI News Service conducted a months-long investigation into what led federal officials to deem Osawatomie State Hospital as a facility too dangerous for Medicare patients and whether officials can rebuild the hospital for a successful future. This is the fifth and final story of the series.

Courtesy Mission Village Living Center

Kansas has not made any advance payments under a program that promised financial help for nursing homes while they wait for residents’ Medicaid applications to process.

Nursing homes were told in March that they could apply for half-payments for their Medicaid-pending residents until the state resolves a backlog of thousands of applications.  

But the state instead has used requests for advance payments to prioritize which Medicaid applications are moved to the front of the processing queue.  

Andy Taylor

Dr. Julie Stewart doesn’t want political candidates and elected officials to show up at her nonprofit medical clinic in Coffeyville for photo opportunities, grant announcements or organized tours.

Instead, the Coffeyville physician would like those officials to take a personal interest in the patients who have chosen Stewart’s Community Health Clinic of Southeast Kansas because they have no health insurance options.

Matt Hodapp / KCUR 89.3

On this week's episode of Statehouse Blend, Missouri Sen. Ryan Silvey (R-Kansas City) talks about transportation funding, the Republican party platform, and this year's gubernatorial election.

Guests:

  • Sen. Ryan Silvey, (R-Kansas City), Missouri House of Representatives
  • Elle Moxley, General Assignment Reporter, KCUR
Andy Marso / Heartland Health Monitor

The state’s Medicaid application backlog is making work more stressful for Angela Moore, executive director of Sharon Lane Health Services in Shawnee.

Moore’s nursing home has 110 employees caring for about 70 elderly and disabled residents, and she has cash flow worries because of persistent problems with the state’s Medicaid eligibility system.

At one point recently she was waiting on Medicaid coverage approval for 17 residents — which means Sharon Lane was providing free care for almost one-fourth of its clients.

Matt Hodapp / KCUR 89.3

On this week's episode of Statehouse Blend, Missouri Sen. Ryan Silvey (R-Kansas City) talks about transportation funding, the Republican party platform, and this year's gubernatorial election.

Guests:

  • Sen. Ryan Silvey, (R-Kansas City), Missouri House of Representatives
  • Elle Moxley, General Assignment Reporter, KCUR
Andy Marso / Heartland Health Monitor

Tim DeWeese highlighted Johnson County’s neediest residents Monday while briefing an audience about what the county is losing because Kansas policymakers have declined to expand Medicaid under the Affordable Care Act.

DeWeese, executive director of the county’s mental health agency, said there are people living under bridges or “surfing” from couch to couch in the state’s most prosperous county — and they didn’t come in from elsewhere.

“There is a homeless population, here in Johnson County,” he said.

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