Kansas, Michigan Asked To Fix Medicaid Glitches

Federal officials have asked six states, including Kansas and Michigan, to submit plans for resolving issues that appear to be delaying the processes to determine Medicaid eligibility, primarily for pregnant women, children and people with disabilities.

Letters were sent to each state’s Medicaid director on June 27.

“CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services.

The six states – Kansas, Alaska, California, Michigan, Missouri and Tennessee – were asked to respond by July 14.

Sara Belfry, a spokesperson for the Kansas Department of Health and Environment, said “there is currently no backlog processing Medicaid eligibility applications.”

In Kansas, she said, all of the state’s Medicaid applications are being processed within the 45-day period that’s allowed by CMS.

The CMS concerns, Belfry said, have more to do with the state and federal government computer systems not sharing information with each other.

“Kansas is preparing an updated processing plan,” she wrote in an email to KHI News Service. “This plan will include the ability to receive full electronic applications directly from the Federal Marketplace, which will improve the efficiency of the KanCare application process.”

KanCare refers to the Kansas’ now-privatized Medicaid and CHIP programs; the marketplace refers to the insurance exchanges that allowed people to enroll in health plans online and played a key role in implementation of the Affordable Care Act.

Kansas did not expand Medicid eligibility as part of the ACA, although Michigan did. It reported more than 323,000 enrollees in its Healthy Michigan plan, surpassing first-year enrollee projections.

In Kansas, the state’s Medicaid application processes are administered by KDHE, the Department for Children and Families, and an eligibility clearinghouse run by Policy Solutions Inc., a Denver-based company.

For much of five years, state officials have been working on a $137 million redesign of the computer systems used to calculate Medicaid eligibility, gather and share data, and let enrollees know if they are eligible for other benefits.

Initially, the new system, called Kansas Eligibility and Enforcement System or KEES, was to be up and running by October 2013. But KDHE officials earlier this year announced the rollout had been delayed.

Belfry said the KEES postponement “probably” instigated the CMS directive.

In the letter, CMS Regional Director Cindy Mann wrote that while Kansas appeared to be in compliance or near-compliance with six of the seven “critical success factors” for ensuring implementation of the Affordable Care Act, it “still does not have the ability to send or receive account transfers from the FFM (federally facilitated marketplace), which interferes with Kansas’ residents’ ability to apply and enroll in Medicaid.”

Mann asked that Kansas submit “an updated mitigation plan” to resolve the current system’s shortcomings.

News of the letters was first reported Wednesday by InsideHealthPolicy, an online trade publication.

Kaiser Health News later noted that five of the six CMS-cited states – California being the exception – had declined to state-run insurance exchanges and instead relied on the federal government’s online marketplace.

California and Michigan have taken steps to expand their Medicaid programs. The other four have not.

Contacted Thursday, several advocates for the state’s uninsured said they were unaware of the CMS letter.

“This is the first I’ve heard of it,” said Sean Gatewood, director of the Kansas Medicaid Access Coalition. “But I have to say we’ve not had many complaints about applications being processed. This, I think, has more to do with CMS saying the system isn’t as seamless as it could be, and we would agree with that.”

Last month, KDHE announced that 426,642 people – or roughly one in seven Kansans – were enrolled in one of the state’s three KanCare plans, a record high.

The KHI News Service is an editorially independent initiative of the Kansas Health Institute.