State official on Kansas Medicaid unwinding: ‘We probably could’ve done a better job’

As of July 31, almost 80,000 Kansans deemed ineligible for Medicaid

By: - August 29, 2023 9:00 am

Sarah Fertig, state Medicaid director, says the first few months of the unwinding process has been difficult. (Sherman Smith/Kansas Reflector)

TOPEKA — After describing long wait times, sluggish mail returns and unprecedented call center volumes, Kansas Department of Health and Environment officials announced — two weeks after their initial update — that they are trying to turn things around in the beleaguered department’s Medicaid renewal system.

“Over the last year or so, we’ve received a number of requests from various stakeholder groups to prioritize various constituencies, so for instance, we got a request to push all children to the end of the public health emergency and rewinding period,” said state Medicaid Director Sarah Fertig in a Aug. 22 presentation to lawmakers. “… We got a lot of requests from stakeholder groups to prioritize their constituency over everyone else. I think you can see how quickly that would become unmanageable.” 

“We would literally be picking winners and losers, depending on what conditions they might have or their age,” Fertig added. “We decided that wasn’t fair. Really the only way we could proceed with this in a fair fashion is to just take them chronologically.”

Pandemic-era federal protections stipulated that KanCare, the Medicaid program in Kansas, couldn’t end health care eligibility unless the person in question moved away, died or asked to end coverage. Participation in KanCare went from 410,000 to 540,000 people during the pandemic. 

When federal protections ended, the nationwide process of determining Medicaid eligibility began in April for the first time in three years. The process has to be completed by early 2024.  KDHE has sent out notices to Kansans with renewal dates in April, May, June and July to allow members to stay eligible.

Fertig said the highest number of renewals happened in these first four months of unwinding — representing  about 40% of the unwinding effort. 

Critics of the process say thousands of Kansans have unnecessarily lost eligibility due to issues such as confusion over signatures, slow mail delivery, and a lack of clear communication from the state about what is needed for the renewal process. 

“We realize that we probably could have done a better job entering the unwinding, just recapping what a renewal is, timelines, processes to the public to help them understand what to expect when we start these processes again,” said KDHE Director of Medicaid Eligibility LaTonya Palmer

Preliminary data as of July 31 shows the state has sent out renewal notices to 283,709 people. Out of this category, 69,876 people have been approved for continuing Medicaid coverage and 78,850 people have been unenrolled. 

The enrollment category includes almost 18,000 people who were determined to be ineligible, but about 61,000 of those enrolled were people who didn’t submit a review within the mandated time frame. State officials stressed these people have 90 days to submit a review to be re-determined for eligibility. 

Child advocacy groups are concerned that Kansas children, who make up more than 62% of KanCare enrollees, will be disproportionately hurt. 

Palmer and Fertig told lawmakers the department had taken some steps to fix early issues, such as increasing staff availability and shortening wait times for Kansans who were calling in to have questions about the process answered.

According to their report, the average call center wait time was 43 minutes in April, 24 minutes in May and 19 minutes in June. By August, phone wait time was about 10 minutes. The two also said the department was increasing quality oversight and coaching, among other measures. 

“We are taking steps to ensure that we are processing these applications as quickly as possible,” Palmer said. 

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Rachel Mipro
Rachel Mipro

A graduate of Louisiana State University, Rachel Mipro has covered state government in Baton Rouge and New Orleans. She and her fellow team of journalists were 2022 Goldsmith Prize Semi-Finalists for their work featuring the rise of the KKK in northern Louisiana, following racially-motivated shootings in 1960. With her move to the Midwest, Rachel is now turning her focus toward issues within Kansas public policies.