Kansas suit focuses on arcane Medicaid eligibility verification process

kdhe-320x240_20130628184113_320_240A recent suit was brought in Kansas over long delays in the Medicaid eligibility determination process. The suit was brought by a chain of nursing homes that has suffered as a result of the delays in processing long-term care Medicaid cases. At issue is the complex and lengthy asset and income verification process. Part of this stems from the 60-month look back period which requires a Medicaid caseworker to investigate transfers of assets for less than fair market value during the past five years.

Finding and assembling these documents for the Medicaid case workers can be time-consuming in itself. This can cause additional delay for Medicaid approval as the caseworkers have to virtually do the work of a forensic accountant and pore through five years’ worth of statements to determine if transfers were made.

Delays in determining eligibility result in delays for payment to the nursing homes. The nursing homes are required to provide care for the patient while they are awaiting Medicaid eligibility determinations. Many facilities find this to be burdensome when the state takes an exorbitant amount of time to determine eligibility. Case backlogs put an undue financial burden on the facilities providing care. This lawsuit hopes to push the state of Kansas to resolve the inefficient processing of long-term care Medicaid cases.

For more information about this suit, click here.