Disability group calling for federal investigation of Medicaid backlog

A state disability organization is calling on the federal government to investigate the state’s handling of the application backlog for Medicaid.

And this week, the Kansas Legislative Division of Post Audit will begin an investigation into the backlog issue.

The backlog was caused in part by the state switching its computer system that processes Medicaid applications about a year ago. And then in January, it switched the agency that oversees the applications, furthering the problem. Medicaid is the state and federal health insurance program for people who are disabled or who have low incomes.

The state thought it had lowered the backlog to 3,480 when it found out that the backlog had been inaccurately reported by its third-party contractor, Accenture.

The backlog was more than four times what the state previously thought – a total of 15,393 backlogged applications, 10,961 of which had been waiting more than 45 days. The spike occurred in mid-May.

The state now says it has lowered the backlog to 11,585 total; 7,724 of those people have been waiting longer than 45 days.

“It’s a modest decrease of the increase,” Sen. Laura Kelly, D-Topeka, a member of the Legislature’s KanCare Oversight Committee, said about the progress.

Roughly 2,500 of the totals reported accounted for “pending” applications, which the state says it can’t process because of incomplete application information.

Angela de Rocha, spokeswoman for the Kansas Department of Health and Environment, said she expects the backlog to be eliminated by the end of the summer.

“We are making progress,” she said.

State audit

Brad Hoff, senior auditor at the Kansas Legislative Division of Post Audit, is in charge of auditing the backlog issue. He said the investigation will focus on three questions: What are the correct backlog numbers? What caused the backlog? What is the state doing to address the backlog?

He said Rep. Louis Ruiz, D-Kansas City, requested the audit. Hoff said the findings would be presented at the Legislative Post Audit Committee meeting Sept. 21.

“Our main focus is not necessarily on the inaccuracies but on the right numbers going forward,” Hoff said.

A letter dated June 10 from Susan Mosier, secretary of the Kansas Department of Health and Environment, to James Scott with the U.S. Centers for Medicare and Medicaid Services detailed the inaccuracies.

Mosier said in the letter that the backlog inaccuracy was created because two groups of applicants weren’t registering on the list: applicants who applied, were denied eligibility and then reapplied, and Medicaid recipients who were applying for a different level of coverage.

The federal government became concerned with the state’s backlog, so it now requires Kansas to submit bi-weekly reports about the backlog’s status and updates about what the state is doing to address it.

State records

The Disability Rights Center of Kansas wants to see first-hand the health department’s records that show its handling of the backlogged applications, and it wants to review the contracts and correspondence with Accenture, the contracted company. It also wants to know if the agency is notifying applicants of their right to appeal after waiting more than 45 days.

Eligibility experts reported an uptick in the number of people being incorrectly denied Medicaid, according to the Kansas Health Institute News Service. So the group also asked for data and information about denied applications under the Kansas Open Records Act.

On Monday, the state acknowledged the organization’s request but didn’t say when it would make the records available.

“That’s not only incredibly disappointing, I think it’s insulting to the thousands of Kansans who have been harmed by the state’s actions,” said Rocky Nichols, executive director of the Disability Rights Center of Kansas.

The organization offered more detail about many of its concerns in its letter to the U.S. Centers for Medicare and Medicaid Services.

“The delays and violations are so widespread and systemic that we ask CMS to take any and all steps needed to protect the rights and health of those in need of Medicaid assistance,” the letter read.

Rep. Dan Hawkins, R-Wichita, who chairs the KanCare Oversight Committee and Health and Human Services Committee, said overall he thinks the state health department has done well reducing the backlog since it ballooned in May.

He said the Disability Rights Center’s letter to the federal government assumes it’s unaware of the issues.

“And that’s a bad assumption,” he said.

“It’s not like they’re in the dark.”

This story was originally published July 12, 2016 at 11:35 AM with the headline "Disability group calling for federal investigation of Medicaid backlog."