After years of complaints about backlogs and mishandled Medicaid applications, the Kansas Department of Health and Environment (KDHE) 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 a lawsuit alleging Medicaid fraud for overbilling dentists in Texas. It was settled last year.
Maximus referred all questions to KDHE.
In a statement to The Star, Conduent touted its experience in other states.
“We bring operational excellence and innovative technology solutions, as well as strong nationwide expertise,” the statement said. “We help our state agency partners adapt to challenges such as policy changes and transitions to new capabilities and solutions, while maintaining high-quality customer service.”
Before Maximus was brought to Kansas, Medicaid applications were handled by state employees. A KDHE spokeswoman said the agency considered discontinuing the outsourcing of Medicaid eligibility, but decided it was not financially feasible.
Lawmakers, attorneys and advocates expressed cautious optimism about the change. Though many predicted continued struggles during a transition and a desire to return to the “good old days” before private business was engaged in the Medicaid application process.