by Andy Marso, KHI News Service
A yearlong backlog of Kansas Medicaid applications is almost gone, but legislators from both parties said Friday that Gov. Sam Brownback’s administration should consider delaying a plan to include applications for social services in the same processing software that contributed to the backlog.
Applications for social programs like food assistance are scheduled to be folded into the Kansas Eligibility Enforcement System, or KEES, in April.
But during a Statehouse hearing, several lawmakers, including Sen. Jim Denning, asked Kansas Department of Health and Environment Secretary Susan Mosier if that should be pushed back given problems with the Medicaid portion of the system.
Mosier said the agency will do “a detailed analysis closer to that date and make the decision,” but right now the rollout date is firm.
“You’re way braver than me,” said Denning, a Republican from Overland Park.
Denning and the rest of the Robert G. (Bob) Bethell Joint Committee for Home and Community Based Services and KanCare Oversight voted to recommend that the state not move forward with the next phase of KEES unless technology experts in the Legislature’s independent auditing department verify that the system is ready.
When the state signed a contract with Accenture in 2011 to develop KEES, the intent was to create a one-stop online shop where Kansans could apply for Medicaid and social services.
But the Medicaid application portion was delayed more than a year and had a rocky rollout when it finally occurred in the summer of 2015.
Rep. Dan Hawkins, a Republican from Wichita, and Rep. Jim Ward, a Democrat from Wichita, both asked why the state would move forward with the KEES social services phase while the backlog of Medicaid applications persists.
Mosier said the state is confident that the backlog will be resolved by April.
“We have steadily improved,” Mosier said. “I hope that you see that.”
A report provided Friday to the KanCare oversight committee showed that KDHE and Accenture had resolved 107 “high defects” within KEES in this year.
KDHE officials also said that though KEES was a factor in the backlog, an administrative change that funneled all Medicaid applications through a single KDHE “Clearinghouse” also contributed, as did a rush of applications referred during last year’s open enrollment period for Affordable Care Act insurance.
“We’ve made significant progress in reducing that backlog,” Mosier said.
In addition to continued KEES troubleshooting, KDHE pumped up staffing at the Clearinghouse and reduced average customer service wait times at its call center from 27 minutes to 46 seconds.
Backlog by the numbers
Applications for Kansas Medicaid, or KanCare, are considered backlogged if they have been pending more than the federal limit of 45 days — unless they require a federal disability designation, in which case the limit is extended to 90 days.
KDHE reported almost 11,000 applications backlogged in May after discovering that the agency had been underreporting the total to federal officials.
Agency officials reported Friday that the backlog was down to about 1,900 applications, with all but 800 of them in some phase of processing.
The KanCare oversight committee voted to recommend KDHE set up a special team tasked with quickly processing all Medicaid long-term care applications pending 45 days or more.
In addition to the costs of added staff to resolve the backlog, the Legislature’s research department projected the state would have to add $4.5 million to its budget for the next fiscal year to pay for retroactive Medicaid claims as Kansans who were previously in the backlog are approved.
Mosier said nearly all of the backlogged applications now are for long-term care coverage for elderly and disabled Kansans. Those applications require extensive information on assets.
Delays in processing them have hit the state’s nursing homes particularly hard financially, as facilities have provided months of uncompensated care for residents while waiting for their applications to process.
KDHE announced in March that it would allow homes to apply for advanced payments for Medicaid-pending residents but had not granted any through July.
The agency now has the program up and running and reported paying out about $2 million to 70 facilities.
Too late for some facilities?
Associations that represent nursing homes said processing times have improved since the beginning of the year but still frequently surpass 45 days.
Christopher Rea, a spokesman for the Kansas Adult Care Executives, said because of cash flow issues caused by Medicaid processing delays and a cut in provider reimbursements, many Kansas nursing homes no longer take new residents who are Medicaid-pending.
Some small homes, Rea said, are simply closing.
“It’s happening, and it’s going to happen even more,” Rea said.
Denning told Mosier he had visited nursing homes in his area and verified the financial pressures.
“It’s the real deal,” Denning said.
Mosier urged legislators to inform her and her staff about individual cases so they could get applications more attention.
She said the cash flow issues should smooth now that the backlog is waning.
“I think you will see a real change in that,” Mosier said.
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