by Rachel Mipro, Kansas Reflector
February 4, 2024
TOPEKA — Kansas is close to determining who will remain eligible for Medicaid after months of glitches and ongoing confusion over how to reapply. Current estimates suggest thousands of Kansans covered during the pandemic will be removed from the system, and health care advocates warn qualified applicants will be kicked off because of processing problems that are out of their hands.
Christine Osterlund, the Kansas Department of Health and Environment’s deputy secretary, said the final Medicaid review mailings have been sent out, giving lawmakers at a health care committee meeting an updated report Friday.
“We are actually getting to the end,” Osterlund said.
The state started the Medicaid review process in April 2023, following the end of pandemic-era protections. During the COVID-19 pandemic, federal “continuous coverage” provisions meant Medicaid administrators couldn’t end health care eligibility unless the person in question moved away, died or asked to end coverage.
As a result, participation in KanCare, the Medicaid program in Kansas, skyrocketed from 410,000 to 540,000 people during the pandemic.
When the unwinding process started in April of 2023, Medicaid enrollment was just over 540,000 members in the state.The April review marked the first time in three years that eligibility had been examined.
KDHE officials got a rocky start to unwinding, with thousands of Kansans unnecessarily losing eligibility due to communication issues, system glitches, slow mail delivery and confusion over the return process.
Kylee Childs, director of government affairs with nonprofit organization LeadingAge Kansas, said there are still process problems for older Kansans and nursing facility service providers who struggle to return their applications.
In the state, nursing facilities receive Medicaid reimbursement starting from the original application date, but state licensed adult care homes, such as assisted living facilities, are reimbursed only when Medicaid applications are approved. These homes have to absorb the costs for Medicaid waiver services while they wait for applications to be approved, according to advocates who have raised concerns over the sluggish wait times.
“Since unwinding began, providers and consumers have faced delayed application times and troublesome technology problems that have made an already arduous process even harder,” Childs said in written testimony. “Our providers have faced difficulties with sending initial applications via fax and receiving confirmation of the fax delivery, only to have the state agency tell them the fax never went to their server.”
Childs spoke about the continued problem of mail delays, mentioning one incident in which a provider received a Medicaid denial letter 15 days after the letter was sent, meaning they missed the 10-day deadline to send additional information to KDHE to keep the application open.
“While KDHE has shared they are willing to collaborate with providers and grant extensions in these scenarios, we would like to see a way to overcome this communication barrier to result in fewer applications needing to be resubmitted,” Childs said.
Mark Schulte, legislative co-chair for the Kansas Adult Care Executives Association, showed similar concern. Schulte said organization members reported Medicaid applications for nursing facilities and adult care home state service waiver applications were difficult to process.
“Reimbursement for both care settings is extremely important, and it’s even more critical that Medicaid waiver applications are processed timelier,” Schulte said in written testimony.
Preliminary data as of Jan. 4 showed the state had sent out renewal notices to 467,818 Kansans. Of these people, 46% have been approved to keep services, and 11.4% — more than 53,000 people — have been unenrolled.
About 22,500 Kansans fall into a third category, in which they are eligible but didn’t submit their renewal notices within the mandated time frame. Kansans in this category have 90 days to submit a review and reinstate eligibility.
Another 12.3% of Kansans need to submit new applications to reapply for Medicaid because they have not completed the review within the 90-day window.
Due to processing delays and shifting data as Kansans undergo review, final results for unwinding will likely not be released for a few more months.
“There’s always a lag,” Osterlund said.
Osterlund said she expects to see coverage rates return to pre-pandemic enrollment numbers and estimated 110,000 to 120,000 Kansans will lose coverage by the end of unwinding.
Kansas Reflector is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Kansas Reflector maintains editorial independence. Contact Editor Sherman Smith for questions: info@kansasreflector.com. Follow Kansas Reflector on Facebook and Twitter.
