State contractor misses deadline to fix problems in KanCare application process

photo by: Kansas Department of Health and Environment

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TOPEKA — A private contractor that processes applications for the state’s privatized Medicaid program known as KanCare failed to meet a June 1 deadline to clear up problems in that process, including a backlog of pending applications.

But Jeff Andersen, Secretary of the Kansas Department of Health and Environment, has not yet said whether the agency will fine Maximus Health Services Inc. for failing to meet its contractual requirements as the agency had previously said it would do.

“Although Maximus has made a good-faith effort to meet our standards, it is not in full compliance with its contractual obligations,” Andersen said in a statement emailed to the Journal-World. “We will be working with Maximus on a partnership going forward. Contract performance will be taken into account as part of the future relationship.”

Maximus, based in Reston, Va., was hired in 2016 to manage what is called the KanCare Clearinghouse. The Clearinghouse processes applications for both Medicaid and the Children’s Health Insurance Program, or CHIP, which are known collectively as KanCare.

Together, the two programs provide health coverage to about 450,000 people in Kansas.

Since 2016, consumers and other health care advocates have complained that thousands of applications are not getting processed within the required 45 days.

Andersen said in a statement that the Maximus contract includes provisions governing both the timeliness of processing applications and accuracy — making sure that people who qualify get enrolled and that those who don’t qualify are not enrolled.

As recently as April, however, the head of one skilled nursing facility in Hillsboro told a legislative oversight committee that the Clearinghouse frequently loses documents and they have to be re-sent multiple times.

“Documents sent to Clearinghouse would somehow disappear and we did a lot of resending,” Peter Mungai, CEO at Salem Home, said in written testimony. “Sometimes we used to be asked for documents again and again. Our facility made several calls to Clearinghouse and sometimes it would take a long time before someone picks up the phone.”

In February, Jon Humdorf, director of KDHE’s Division of Health Care Finance, told a legislative oversight committee that if Maximus did not resolve issues at the Clearinghouse by June 1, the agency would impose “liquidated damages” for noncompliance with the contract, retroactive to Jan. 1, according to official minutes of that meeting.

According to state records, Maximus was paid $25.1 million in fiscal year 2017, the most recent time period for which numbers are available.

Officials at KDHE were not able to confirm how large an application backlog exists currently. Officials at Maximus did not respond to a request for comment.


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