Medicaid

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.”

The two Planned Parenthood organizations in Kansas and Missouri wasted little time challenging Kansas’ termination of their Medicaid funding.

Just a day after the Kansas Department of Health and Environment notified them of its decision to cut off their Medicaid payments,  Planned Parenthood of Kansas and Mid-Missouri and Planned Parenthood of St. Louis Region sued the head of the agency, Susan Mosier.

Gov. Sam Brownback’s administration will not fight a legislative directive to postpone the integration of Medicaid waiver services for Kansans with disabilities, according to an email sent by an administration official.

The Legislature passed a budget early Monday that included a provision prohibiting spending in the next fiscal year on any waiver integration plan to be implemented before July 2018.

The Kansas Legislature added several patient protection measures to a bill allowing “step therapy” for Medicaid drugs before passing the legislation early Monday morning.

Advocates for Kansans with mental illness and other conditions were pleased with the changes but remain concerned about the possible effects of the underlying bill on vulnerable patients.

Step therapy requires Medicaid patients to try the least expensive medications for treating their ailments first. If those fail, they can then “step up” to a more expensive alternative.

Legislative budget negotiators have agreed to insert a provision in the state budget preventing Gov. Sam Brownback’s administration from consolidating Medicaid support services for Kansans with various disabilities.

The Medicaid waiver integration plan has been a point of contention between the administration and a legislative subcommittee appointed to study the issue. The subcommittee issued a report recommending the integration be delayed a year to Jan. 1, 2018, and requesting more details on the plan.

Federal officials have reversed position on a long-standing ban on paying for some inpatient psychiatric care, giving a possible boost to Kansas crisis centers.

The Centers for Medicare and Medicaid Services released a proposed rule Monday that will place new requirements on managed care organizations administering Medicaid, such as the three insurance companies that operate KanCare, the state’s privatized $3 billion program.

Members of the Legislative Post Audit Committee again declined Tuesday to request an investigation into whether the Kansas Department for Children and Families has placed children in risky situations because of a preference for heterosexual foster parents.

Rep. Jim Ward, a Democrat from Wichita, first requested the audit in December after reports surfaced of DCF removing a baby from the home of a lesbian couple in Wichita and placing it with a heterosexual Topeka couple who subsequently were charged with child abuse.

Two employees of Larned State Hospital made rare public comments Monday about difficult working conditions at the mental health facility.

Kyle Nuckolls and Lynette Lewis described for a legislative committee the toll that mandatory overtime and limited time between shifts is taking on workers at the short-staffed facility and their families.

“I’ve never seen it this bad,” said Lewis, a pharmacy technician who has worked at Larned for 18 years.

Representatives of 15 groups that advocate for Kansas Medicaid populations sent a letter to state leaders this week urging them to eliminate a Medicaid application backlog that has left thousands of Kansans awaiting coverage.

The groups have formed a coalition called the KanCare Advocates Network. They represent children, pregnant women and Kansans who are elderly or disabled.

Kansans from those populations have been waiting months, in some cases, for their Medicaid applications to process.

Editor’s note: A backlog of Medicaid applications has caused financial strain for nursing homes and put thousands of Kansans at risk for loss of medical care. State officials trace the beginnings of the backlog to a computer system switch.

A statewide registry is in the works to make it easier for Medicaid patients to find qualified, reliable personal care workers.

That’s good news for Bill Stovall of Topeka and others like him who help direct care for their family members.

Stovall has a long list of complaints against personal care workers who have cared for his sister in recent years, including punctuality problems and a lack of training.

Nursing home representatives breathed a sigh of relief Friday as the state announced a program to help them get Medicaid money for some residents whose applications are stuck in processing delays.

The delays — traced back to a computer system switch in July and administrative changes in January — have led to thousands in unpaid bills for facilities and prevented some frail Kansans from finding a nursing home bed.

A new organization is forming to strengthen the lobbying effort for Medicaid expansion in Kansas.

The Alliance for a Healthy Kansas will focus on passing an expansion bill in 2017, not in the waning days of the current session, according to Billie Hall, the chief executive of the Topeka-based Sunflower Foundation.

In an email sent Wednesday to approximately 2,000 people registered to receive updates from the foundation, Hall urged individuals and organizations from across the state to join the alliance so that it can mount a strong lobbying effort next year.

Kansas lawmakers are close to finishing their work on a bill they hope will motivate doctors and dentists to provide more charity care.

Though the measure enjoys bipartisan support, its most ardent supporters are Republican legislators who are opposed to Medicaid expansion and need something that shows voters they’re willing to help poor Kansans gain access to health care.

Federal officials are concerned about a growing backlog of Kansas Medicaid applications and have asked state leaders to provide regular updates about what they're doing to fix the problem.

James Scott, associate regional administrator for the federal Centers for Medicare and Medicaid Services sent a letter to Kansas Department of Health and Environment officials Feb 17, citing concerns about “recent reports" of the Medicaid application backlog in the state of Kansas.”

Scott asked KDHE to submit within 14 days a plan to correct the backlog.

Poll results released Monday by the Kansas Hospital Association show a majority of Kansans continue to favor expanding Medicaid to cover more low-income adults.

The statewide poll conducted in mid-February found that 62 percent of Kansas voters supported expanding KanCare, the state’s privatized Medicaid program, to cover approximately 150,000 non-disabled adults earning up to 138 percent of the federal poverty level, or $16,243 for an individual and $33,465 for a family of four in 2015.

Judy Kregar is not a member of the Rotary Club in nearby Greensburg, but she decided to go when she heard Gov. Sam Brownback would be at the club’s recent meeting.

Kregar, the administrator of a small nursing home in nearby Bucklin, wanted to tell Brownback in person about the struggles some of her residents are having getting their Medicaid applications and annual renewals processed.

Proponents of expanding Medicaid eligibility in Kansas need to change tactics and prepare for a long process, a health policy researcher told them Wednesday.

Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University in northern Virginia, said Kansans who currently oppose expanding Medicaid aren’t likely to be persuaded by statistics from “eggheads” like himself.

Kansas’ rejection of Medicaid expansion has cost the state more than $1 billion, according to the association that represents the state’s hospitals.

“This 10-figure sum represents a loss of nearly 11 Kansas taxpayer dollars every second since Jan. 1, 2014 — funds that go to the federal government to be spent in other states for Medicaid expansion,” the Kansas Hospital Association, which keeps a running total of the amount on its website, said in a news release issued Monday.

Sen. Mary Pilcher-Cook offered an amendment to expand Medicaid last week because she believed it would fail.

A few days later, Senate President Susan Wagle removed Pilcher-Cook as chairwoman of the Senate Public Health and Welfare Committee because Pilcher-Cook pushed the amendment even though it was ruled out of order.

Wagle said she opposes Medicaid expansion but wants the Senate to vote on it in the next few weeks.

Confused yet? Welcome to the politics of “Obamacare.”

Pilcher-Cook’s amendment

A spat over Medicaid expansion and Senate rules caused the leader of the Kansas Senate to replace the chairwoman of the Senate Public Health Committee on Friday.

Senate President Susan Wagle, a Republican from Wichita, said in a statement released Saturday morning that Sen. Mary Pilcher-Cook “showed a complete disrespect for the body and its rules” earlier in the week.

Some supporters of Medicaid expansion say that Gov. Sam Brownback’s rural health task force is little more than political cover. They say that in an election year Republican lawmakers opposed to expansion need to be seen as doing something about the financial pressures that forced a hospital in southeast Kansas to close its doors and that are threatening others.

But Lt. Gov. Jeff Colyer, the person appointed to lead the group, says the governor’s critics have it wrong.

House members were denied a vote on Medicaid expansion on procedural grounds in a floor debate Wednesday that mirrored one the Senate had a day earlier.

Rep. Jim Ward, a Democrat from Wichita, tried to attach the amendment to enact expansion during the beginning of an hours-long debate on the state budget.

“This is vital to the future of Kansas,” Ward said, adding that expanding Medicaid eligibility under the Affordable Care Act would extend coverage to about 150,000 low-income Kansans and draw federal funds to help struggling hospitals.

A new computer system for enrolling Kansans in Medicaid and other public assistance programs will generate far less than the expected $300 million in savings, a Legislative Post Audit report finds.

The Kansas Eligibility Enforcement System (KEES) was intended to be a central portal where people could apply for benefits like Medicaid, food stamps and cash assistance, and the state could automatically verify their eligibility.