According to Christine Osterlund, the deputy director of Medicaid operations at the Kansas Department of Health and Environment, around 100,000 Kansans who are enrolled in Medicaid may no longer have access to essential services. This is due to the fact that eligibility assessments, which were temporarily halted during the pandemic, are set to resume.
Kansas is on the verge of finalizing the eligibility criteria for Medicaid, following a period of uncertainty and technical issues that have marred the reapplication process. It is anticipated that a significant number of individuals currently covered under Medicaid during the pandemic may lose their coverage, while qualified applicants face the risk of being wrongfully excluded due to inherent processing challenges. This unfortunate situation places the fate of thousands of Kansans in jeopardy, as they navigate through a system plagued by glitches and administrative confusion.
Christine Osterlund, Deputy Secretary of the Kansas Department of Health and Environment, announced that the updated report on Medicaid review has been sent out to lawmakers. This was shared during a health care committee meeting on Friday.
“We’re nearing the finish line,” Osterlund exclaimed.
The Medicaid review process was initiated by the state in April 2023, after the expiration of pandemic-related safeguards. Throughout the COVID-19 pandemic, Medicaid administrators were unable to terminate healthcare eligibility due to federal “continuous coverage” provisions, unless the individual relocated, passed away, or requested to discontinue coverage.
During the pandemic, the number of people participating in KanCare, the Medicaid program in Kansas, increased significantly from 410,000 to 540,000 individuals.
In April 2023, when the process of unwinding began, the state had a Medicaid enrollment of just over 540,000 members. This review in April was the first time in three years that eligibility had been assessed.
KDHE officials had a difficult start in unraveling the situation, as numerous Kansans lost their eligibility due to issues with communication, glitches in the system, delays in mail delivery, and confusion regarding the return process.
According to Kylee Childs, the director of government affairs at LeadingAge Kansas, older Kansans and nursing facility service providers are still facing challenges in returning their applications due to ongoing process issues.
Nursing facilities in the state receive Medicaid reimbursement from the original application date. However, state licensed adult care homes, like assisted living facilities, are only reimbursed when Medicaid applications are approved. This means that these homes have to cover the costs for Medicaid waiver services while they wait for applications to be approved. Advocates have raised concerns over the slow wait times, highlighting the financial burden this places on these care homes.
In written testimony, Childs expressed frustration with the challenges faced by providers and consumers during the unwinding process. The application times have been delayed, and there have been technology problems that have compounded the difficulties. For instance, providers have encountered issues when sending initial applications via fax and receiving confirmation of delivery, only to be told by the state agency that the fax never reached their server.
Childs highlighted the ongoing issue of mail delays, recounting a specific incident where a provider received a Medicaid denial letter 15 days after it was sent. This resulted in them missing the 10-day deadline to submit additional information to KDHE and keep their application active.
Childs expressed the desire for a more efficient communication process between KDHE and providers to reduce the need for resubmitting applications. Although KDHE has offered to work together with providers and grant extensions, Childs believes that finding a solution to overcome this communication barrier would result in fewer applications needing to be resubmitted.
Mark Schulte, the legislative co-chair of the Kansas Adult Care Executives Association, expressed similar concerns. According to Schulte, members of the organization have encountered challenges in processing Medicaid applications for nursing facilities and adult care home state service waiver applications.
In written testimony, Schulte emphasized the significance of reimbursement in both care settings and stressed the need for Medicaid waiver applications to be processed more promptly.
As of January 4th, preliminary data reveals that renewal notices were sent to 467,818 Kansans. Out of this group, 46% have been granted approval to continue receiving services, while a significant portion of 11.4%, which accounts for over 53,000 individuals, have unfortunately been unenrolled.
Approximately 22,500 Kansans are classified under a third category, where they are eligible for renewal but failed to submit their renewal notices within the required timeframe. Individuals falling under this category have a grace period of 90 days to submit their review and reinstate their eligibility.
Approximately 12.3% of Kansans are required to submit new applications in order to reapply for Medicaid. This is due to the fact that they have not completed the necessary review within the allotted 90-day timeframe.
Final results for unwinding may not be released for a few more months due to processing delays and shifting data as Kansans undergo review.
Osterlund explained that there is always a delay.
Osterlund expects that the coverage rates will revert back to the levels seen before the pandemic, and she estimates that around 110,000 to 120,000 Kansans will no longer have healthcare coverage by the time the unwinding process is complete.