Medicaid

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. 

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.

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.

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.

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.

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.

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.

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.