Delays in processing Medicaid applications in Kansas have put financial strain on nursing homes and threatened coverage for thousands of Kansans and the backlog is on its way back up.
As the Kansas Health Institute News Service reports, over the past year, providers that rely on Kansas Medicaid, or KanCare, have been stung by delayed payments as they wait months for eligibility determinations that by federal rule are supposed to take no more than 45 days.
Nursing homes have been among the hardest hit because about half of residents rely on Medicaid to pay for long-term care, and those kinds of applications are the most complex type within Medicaid.
The backlog in processing Medicaid applications began last summer with the rollout of the Kansas Eligibility Enforcement System (KEES) to replace the much slower paper-based enrollment system, and grew at the end of last year, when a change made by Gov. Sam Brownback funneled all Medicaid applications through a single KanCare Clearinghouse run by the Kansas Department of Health and Environment.
Thousands of applications were handed off to Clearinghouse workers who didn’t have experience processing them, so the backlog grew to nearly 11,000 applications within a few months.
Over this past summer, the state brought new workers in and some from the Department of Children and Families, who were experienced with processing the applications, and the backlog was reduced to about 1,500 applications and state officials assumed the backlog would disappear altogether by September, but that didn’t happen.
Since then, the backlog has climbed to over 2,200 pending applications 45 or more days old and the number of applications pending 15 days or less has also grown a lot since open enrollment period for Affordable Care Act insurance began in November.
This has some concerned that the backlog might never be cleared up, as the financial strain of coverage delays is beginning to impact other state services and local governments.
A report released last month by Leavitt Partners, a health policy consulting shop, stated that the cost burden for the backlog is beginning to shift to areas like Adult Protective Services, which seeks to remove vulnerable adults from abusive situations and place them in safer environments, like nursing homes.
Oftentimes, APS referrals have not yet or are in the process of having Medicaid eligibility established, so nursing homes wait months to find out, in some cases, that the residents are not eligible. This has led many nursing homes to change their policies and accept APS referrals only after they are Medicaid approved.
