Medicaid

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.

File photo

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.

Heartland Health Monitor

The Disability Rights Center of Kansas is seeking more information from the state about its backlog of Medicaid applications to determine whether Kansas is breaking federal rules.

Rocky Nichols, the center’s executive director, said the organization has filed an open records request to examine whether the state is doing what the federal Centers for Medicare and Medicaid Services requires for Medicaid applicants stuck in the backlog.

Sarah Long / Joyful Photography

Funding cuts and changes for children’s programs across the state became a reality at the start of this month — and that means fewer Kansas families will receive some services.

An official with TARC, a Shawnee County organization that serves people with developmental disabilities, said the nonprofit was out of options for administrative cuts in the wake of state funding reductions.

Carolina Hidalgo / St. Louis Public Radio

The four Republican candidates for Missouri governor kicked off their debate Wednesday night with a variety of statements about the Affordable Care Act and Medicaid expansion. KCUR fact-checked some of those statements. Here’s what we found:

Catherine Hanaway:

“Obamacare has failed in every regard. We were told it was going to reduce premiums. On average, premiums went up for the exchange in Missouri over 23 percent last year.”

File photo

The Kansas Hospital Association is urging federal officials to stop Gov. Sam Brownback from implementing $56.4 million in Medicaid cuts set to take effect today.

Brownback ordered the cuts in May to cover shortfalls in the fiscal year 2017 budget approved by the Legislature. The hospital association is asking the federal Centers for Medicare and Medicaid Services to immediately intervene to stop the cuts, which include a 4 percent reduction in provider payments.

Susie Fagan / KHI

Supporters of Medicaid expansion are kicking off a campaign to mobilize Kansas voters on the issue. Federal tax rules prohibit the nonprofit Alliance for a Healthy Kansas from engaging in direct political activity, so the group is mounting a vigorous educational campaign through a series of community meetings across the state. 

Andy Marso / Heartland Health Monitor

News of a mistake that dropped several thousand Kansans from state Medicaid backlog reports has advocates and Democratic lawmakers questioning the state’s oversight of the contractor blamed for the error.

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.

File photo

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.

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