The Rocky Transition to KanCare
In recent months it's become more difficult to receive notice that your Medicaid Application has been approved. And this has made it especially difficult for providers like nursing homes and home health agencies to continue to offer their services while they wait for a very long time for that coveted Notice of Approval.
Nationwide this has become a real problem due to provisions of the Affordable Care Act which requires states, in many instances, to improve outreach and enrollment for Medicaid while coordinating eligibility with the new health benefit exchanges.
In Kansas, this has been a perfect storm since the state has been dealing with these issues while switching to the privatized program known as KanCare.
Back in July of 2015 the state switched to new software-the Kansas Eligibility Enforcement System to determine eligibility, and then in January of this year the Kansas Department of Health and Environment took over the responsibility for processing eligibility for Medicaid. Formerly these eligibility determinations were handled by the Kansas Department for Children and Families.
Reports state that software glitches and bugs require employees to use dozens of time-consuming work arounds and as they have become accustomed to the system, pushing the applications through Department of Health and Environment has created a bottleneck with thousands of Medicaid applications waiting to be approved.
How can you help to speed the process along on the applications that you submit? In this new environment, it is crucial that you submit applications which are complete with no missing information and where eligibility should be established as soon as the case worker reviews it. If you get into the dreaded "request for additional information" process, at a time when thousands of applications are waiting to be approved, your Notice of Approval may be months away.
When we submit Medicaid applications, it is our expectation that they will be approved as soon as they are reviewed. They are thorough and accurate and complete. While not every application is approved during the first review, that is our stated goal and the standard by which we operate. That is crucial in this difficult environment as the transition to KanCare continues.
If you would like information on how we can train your staff to meet that goal and expectation, please contact our office.