Kansas replaces troubled Medicaid contractor, Maximus

After years of complaints about backlogs and mishandled Medicaid applications, the Kansas Department of Health and Environment is parting ways with Maximus, the private for-profit company that administered the KanCare clearinghouse.

One of the firms hired by former Gov. Sam Brownback’s administration to bring lower costs and private sector efficiency to state government, Maximus instead got poor marks for processing applications and operating KanCare’s customer service call center.

Nursing homes, which rely heavily on Medicaid reimbursements, reported financial struggles as the number of seniors covered by the federal-state health insurance program dropped despite an increasing elderly population. In 2019, Governor Laura Kelly announced plans to hire 300 state workers to take the most complex Medicaid applications away from Maximus.

Instead of bringing the entire Medicaid screening operation back in-house, Kansas has hired another private contractor beginning next year. The New Jersey-based Conduent has had its own troubles. Among them was

Read More Read more

Spotlight Team probe: Potential Medicaid discrimination at Massachusetts nursing homes

The replies etched a clear pattern. Nursing homes were more than twice as likely to say they had no room when responding to inquiries from families saying they planned to pay for care with Medicaid — the government health program relied on by low-income residents — rather than paying privately.

Often the difference wasn’t subtle. In some cases, employees from the same facility would tell the daughter of a purported Medicaid applicant that there was a waiting list, while telling the daughter of a private payer, who could be expected to pay the nursing home nearly twice as much, she would be happy to discuss the options.

Discrimination against applicants covered by Medicaid has existed for years in the nursing home industry, say advocates for the elderly, and it can be illegal.

Massachusetts adopted explicit protections in 1994, barring nursing homes from discriminating against “any Medicaid recipient or person eligible

Read More Read more