Editor’s note: This story was updated at 4 p.m. July 11 with comment from a state spokeswoman.
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.
“We are concerned that the state is not informing Kansas Medicaid applicants of their right to a fair hearing if their application is not processed within 45 days,” Nichols said Monday via email. “We are also concerned that they are not enrolling people who fell through the cracks or providing them retroactive benefits. Thus far, the state has produced no tangible evidence that they are complying with these aspects of federal law.”
Angela de Rocha, a state agency spokeswoman, said federal rules do not obligate the state to inform applicants of their right to a fair hearing after 45 days.
But she said the website for Kansas Medicaid, or KanCare, provides information on the fair hearing process.
“In addition, the KanCare Ombudsman routinely advises consumers of their fair hearing rights,” de Rocha said via email.
The backlog began last year when the state and a contractor, Accenture, rolled out a new computer system for determining Medicaid eligibility.
The system, which took longer to build than promised, did not meet accuracy or timeliness guidelines set when Accenture won the contract years earlier.
A Jan. 1 administrative change that funneled all applications through one state agency — the Kansas Department of Health and Environment — created a bottleneck in the middle of the Affordable Care Act open enrollment period, which worsened the backlog.
Federal officials with CMS began requesting twice-monthly updates on the situation in February.
Those updates had shown the backlog being steadily whittled down. But last month KDHE Secretary Susan Mosier sent a letter to CMS, informing the federal agency that previous updates were erroneous and the backlog was almost 12,000 applications higher.
She and other state officials blamed Accenture for the error. Accenture officials said they had correctly given the state the data it requested and state officials had subsequently changed their request.
In addition to filing the request under the Kansas Open Records Act, Nichols said his organization has sent a letter to CMS.
“The letter to CMS is about engaging them to have CMS use its powers under federal law, which are significant,” Nichols said, “in order to hold the state accountable for these compliance issues.”