KDHE promises to decrease Medicaid backlog

TOPEKA (AP) — The Kansas Department of Health and Environment said Wednesday it is taking steps to reduce the state’s backlog of nearly 2,700 Medicaid applications for residents of nursing homes, including more advanced payments and a hotline to assist facilities.

In a meeting of the House Health and Human Services Committee, providers said they are struggling because of the backlog. In many cases, homes are providing care for months while they wait for a patient’s Medicaid eligibility to be approved.

Patricia Ross, administrator and CEO of Mission Village Living Center in Horton, said her facility has had to wait months for several residents to have their applications approved, costing the home more than $10,000 each for several residents. At some points, the facility hasn’t been able to pay its vendors and has been charged late fees, she said. Her written testimony to the committee said Mission Village is still owed $40,000 that it paid for care for residents with pending applications.

Kansas’ 2,663-application backlog is down from a high of 10,961 pending applications in May. Many of the applications are unprocessed. Others are backlogged while KDHE awaits documents from the applicant or because the applicant was previously denied and is applying again.

To decrease the backlog, State Medicaid Director Mike Randol said KDHE has increased the amount of advanced pay it will send to facilities with pending applications. Randol said KDHE would also set up a hotline for nursing homes, publish a checklist for facilities to assist patients, create a webinar for nursing home staffs and use staff members from the Department of Children and Families, which used to handle the applications, to assess and improve the situation.

Rep. Les Osterman, a Wichita Republican, said points in the plan sound good but he wanted to know how soon they would be implemented.

“If you’re going to say you’re going to do something, then you’ve got to have a plan of when you’re going to do it and when is it going to be in place,” he said.

Lori Palmer, director of revenue management for the employee-owned facility Medicalodges, said the changes would be great if they happen, but that advanced payments are difficult for homes to get.

The backlog has been a problem for more than a year, and Rachel Monger, vice president of government affairs for Leading Age Kansas, said it started with the state’s new application processing software KEES. It worsened, she said, last January when responsibility for the process moved from the DCF to KDHE and was contracted out to a private contractor.

Randol said the state and its contractor have added staff members to reduce the backlog and made workflow and technology improvements.

Committee Chairman Daniel Hawkins, a Wichita Republican, said he planned to request a legislative audit of the eligibility-processing system and department operations.