Feds troubled by processing delays in Kansas Medicaid applications

Backlog has been a persistent problem

0 | KHPA, Legislature, Health Care Delivery

— Federal officials have asked the Kansas Health Policy Authority to explain why thousands of Medicaid applications haven’t been processed in a timely manner.

According to a April 22 letter from the Centers for Medicare and Medicaid Services (CMS), approximately 8,100 Medicaid applications and roughly 5,300 renewals have been “pending” for more than 45 days.

States are subject to penalties when Medicaid applications and renewals sit for more than 45 days. Both are subject to eligibility review, a process that involves confirmation of citizenship, income and family size.

Medicaid beneficiaries must apply annually.

The CMS letter asked the health policy authority to confirm the counts and provide an “action plan” for expediting the process for determining eligibility.

“This is a serious situation,” said Peter Hancock, a spokesman for the health policy authority. “In many cases, the delay in processing means delays in people getting needed medical care. Other times, it means people incurring personal expenses they can’t afford to get medical care.”

Hancock said agency officials are “...hopeful we can find other resources we can devote to this.”

But those resources and their availability, he said, have yet to be determined.

For much of the past year, health policy authority officials have warned legislators that budget cuts were hindering their ability to keep pace with ever-increasing numbers of people – parents and pregnant women, mostly – applying for Medicaid or HeathWave on behalf of their children.

The House-passed budget bill approved Monday by the Senate did not address the delays in processing.

“We turned a deaf ear to the health policy authority in putting the budget together this year,” said Sen. Laura Kelly, D-Topeka. “They’ve told us on more than one occasion how difficult it is for them to meet their statutory requirements when we keep reducing their budget. I’d say their predictions are coming to fruition."

Kelly said she expects the health policy authority to do what it can to address CMS’ concerns.

“I trust the folks at KHPA to set priorities and reallocate resources as much as they’re allowed to meet the most pressing needs,” she said. “It appears that getting rid of the backlog is one of those needs.”

The delays have caused serious cash flow problems at the state’s safety-net clinics.

“These are some extremely challenging times for our members, financially” said Cathy Harding, executive director at Kansas Association for the Medically Underserved, an association representing the state’s safety-net clinics.

“First, they’re all seeing more and more people who are uninsured and then they got hit with the 10 percent cut in Medicaid reimbursement,” Harding said. “That’s a bad combination, but the thing that’s putting the most strain on clinics now is the slowdown in cash flow. They’re seeing people who‘ve applied for – and who are eligible for - Medicaid or HealthWave and four and five months go by before they can get paid. That’s a long time to wait."