Medicaid

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

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.

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.

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.

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.

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.

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.

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.  

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.

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.

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.

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.

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.

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.

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. 

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.

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.

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.

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.

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.

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.

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.

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.”