Kansas
Kansas court sides with Stormont Vail in Medicaid payment dispute
Stormont Vail Healthcare is in a legal battle with the state government, alleging the Medicaid program was wrong to refuse payment for the hospitalization of a pregnant patient with complications.
At issue is a disagreement between the Topeka hospital and the Kansas Department of Health and Environment over whether inpatient health care services were medically necessary for the Medicaid patient’s last two weeks of pregnancy.
The Kansas Court of Appeals did not resolve that dispute, but it did side with Stormont Vail in a May 8 decision. The unanimous three-judge panel reversed a decision by Shawnee County District Court Judge Thomas Luedke and vacated an order from KDHE’s State Appeals Committee. The matter now goes back to the appeals committee for reconsideration.
The appellate panel was comprised of Judges Jacy Hurst, Thomas Malone and Stephen Hill, which heard oral arguments on Aug. 5. Hurst wrote the court’s opinion.
The lawsuit stems from a 2018 case of a pregnant patient, who is not named in appellate court documents. She was 28 years old at the time and had an intellectual disability among other complications, including rapid weight loss caused by hyperemesis gravidarum.
The woman was originally admitted at Newman Regional Health in Emporia before she was transferred to Stormont Vail. Part of the hospitalization during her third trimester was covered.
But the final two weeks were not because Sunflower Health Plan, one of the managed care organizations in the state’s privatized Medicaid program known as KanCare, refused to reimburse for the patient’s continued hospitalization through the day the child was born via cesarean section.
“We are here because the Kansas Medicaid program has wrongfully refused to pay for some of an inpatient hospitalization while a Medicaid beneficiary was at Stormont Vail,” said Amanda Wilwert, an attorney for the hospital, during oral arguments. “Stormont believes the inpatient care was medically necessary as defined by the Kansas Medicaid regulations.”
Court records and oral arguments show the state expected Stormont Vail to look into having a home health agency care for the patient in Emporia instead of continued hospitalization — even though home health generally does not take care of pregnant patients and her doctors believed the expectant mother was not stable enough to discharge.
“The way it’s supposed to work,” said Darren Sharp, an attorney representing KDHE, “is the managed care organization, in this case Sunflower Health, on behalf of KDHE reviews the medical records, asks about the appropriate level of care and whether there’s any other interventions that would be more cost effective or appropriate depending on the level of or depending on the patient’s records and the patient’s status.”
Sharp argued medical records showed the patients was getting better because of total parenteral nutrition, or TPN.
“This is when a tube, a PICC, is inserted and your minerals and your electrolytes and all of your nutrition is then intravenously provided,” Sharp said.
He said the treatment “was eliminating her vomiting, her diarrhea, she had no fever, her glucose levels were stabilized.”
In their ruling, the judges indicated the KDHE appeals committee primarily cared about the cost saving of using home health versus hospitalization while disregarding the treating physician for insufficient reasons and ignoring evidence on potential benefits or harms to the patient.
But the judges declined to resolve the dispute. Rather, unless the decision is appealed to the Kansas Supreme Court, the matter goes back to the KDHE administrative process.
There, the agency’s appeals committee must reconsider the case consistent with the Court of Appeal’s ruling. The published decision sets new precedent interpreting state laws and regulations on the Medicaid program.
“While this court provides no opinion on whether the disputed inpatient healthcare services met the definition of medical necessity,” Hurst wrote, “the record shows that some of the (appeals committee’s) factual findings were not supported by the record as a whole and that the (appeals committee) inaccurately applied the law when it failed to consider (the patient’s) individual characteristics and assess the harms and benefits of the healthcare intervention.
“In making a medical necessity determination, the reviewing agency must make an individualized determination based on the record as a whole.”
Jason Alatidd is a Statehouse reporter for The Topeka Capital-Journal. He can be reached by email at jalatidd@usatodayco.com. Follow him on X @Jason_Alatidd.
Cooler temperatures today, but we will keep a chance of thunderstorms going in south-central Kansas this morning. One or two could be strong.
Temperatures stay cooler in southern Kansas thanks to clouds and rain in the area. Warmer temps and sunshine to the north.
Another chance of severe weather will visit Kansas this weekend, with a complex of strong storms rolling across the area Saturday night.
KSN Storm Track 3 Forecast from Meteorologist Jack Maney:
Wichita:
Today: Mostly cloudy. 60% chance of showers and storms. Hi: 80 Wind: NE 8-18
Tonight: Mostly to partly cloudy. 10% chance of showers. Lo: 62 Wind: NE/E 5-15
Tomorrow: Partly cloudy. 20% chance of showers and storms. Hi: 85 Wind: E/SE 5-15
Tomorrow Night: Partly to mostly cloudy. 30% chance of showers and storms. Lo: 68 Wind: SE 5-15
Wichita Weekly
Sat: Hi: 87 Lo: 73 Partly to mostly cloudy. 50% chance of showers and storms.
Sun: Hi: 92 Lo: 67 Mostly cloudy. 30% chance of showers and storms.
Mon: Hi: 82 Lo: 65 Partly cloudy. 10% chance of showers and storms.
Tue: Hi: 84 Lo: 66 Partly cloudy. 10% chance of showers and storms.
Wed: Hi: 86 Lo: 68 Partly cloudy. 20% chance of showers and storms.
Thu: Hi: 88 Lo: 69 Partly cloudy. 10% chance of showers and storms.
SOUTHWEST: Dodge City, Garden City, Liberal, Greensburg, Guymon
Southwest:
Today: Partly to mostly cloudy. 20% chance of showers and storms. Hi: 84 Wind: NE/E 10-25
Tonight: Mostly to partly cloudy. Lo: 58 Wind: E/SE 5-15
Tomorrow: Partly cloudy. 20% chance of showers and storms. Hi: 85 Wind: SE 8-18
Tomorrow Night: Partly to mostly cloudy. 30% chance of showers and storms. Lo: 62 Wind: SE 5-15
Southwest Weekly
Sat: Hi: 92 Lo: 66 Mostly cloudy. 40% chance of showers and storms.
Sun: Hi: 91 Lo: 59 Mostly cloudy. 20% chance of showers and storms.
Mon: Hi: 82 Lo: 58 Mostly cloudy. 30% chance of showers and storms.
Tue: Hi: 83 Lo: 60 Mostly to partly cloudy. 30% chance of showers and storms.
Wed: Hi: 85 Lo: 61 Partly cloudy. 20% chance of showers and storms.
Thu: Hi: 89 Lo: 62 Partly cloudy. 10% chance of showers and storms.
NORTHWEST: Colby, Goodland, Hill City, Oberlin, McCook
Northwest:
Today: Partly cloudy to mostly sunny. Hi: 86 Wind: NE/E 5-15
Tonight: Mostly clear to partly cloudy. Lo: 61 Wind: E/S 5-15
Tomorrow: Partly cloudy. 20% chance of showers and storms. Hi: 86 Wind: S/SE 8-18
Tomorrow Night: Partly cloudy. 20% chance of showers and storms. Lo: 61 Wind: SE 5-15
Northwest Weekly
Sat: Hi: 90 Lo: 61 Partly to mostly cloudy. 50% chance of showers and storms.
Sun: Hi: 84 Lo: 55 Mostly cloudy. 20% chance of showers and storms.
Mon: Hi: 78 Lo: 56 Mostly to partly cloudy. 30% chance of showers and storms.
Tue: Hi: 82 Lo: 58 Partly cloudy. 30% chance of showers and storms.
Wed: Hi: 85 Lo: 59 Partly cloudy. 20% chance of showers and storms.
Thu: Hi: 87 Lo: 60 Partly cloudy. 10% chance of showers and storms.
NORTHCENTRAL: Salina, Great Bend, Hays, Russell, Beloit, Osborne
North Central:
Today: Mostly to partly cloudy. 10% chance of showers and storms. Hi: 83 Wind: NE 8-18
Tonight: Partly cloudy. Lo: 60 Wind: NE/SE 5-15
Tomorrow: Partly cloudy. 20% chance of showers and storms. Hi: 86 Wind: SE 8-18
Tomorrow Night: Partly to mostly cloudy. 30% chance of showers and storms. Lo: 66 Wind: SE 5-15
North Central Weekly
Sat: Hi: 88 Lo: 70 Partly to mostly cloudy. 70% chance of showers and storms.
Sun: Hi: 88 Lo: 63 Mostly cloudy. 30% chance of showers and storms.
Mon: Hi: 81 Lo: 62 Mostly to partly cloudy. 10% chance of showers and storms.
Tue: Hi: 84 Lo: 64 Partly cloudy. 20% chance of showers and storms.
Wed: Hi: 86 Lo: 66 Partly cloudy. 20% chance of showers and storms.
Thu: Hi: 88 Lo: 67 Partly cloudy. 10% chance of showers and storms.
WICHITA, Kan. (KSNW) — A Kansas fire department is asking people to be more careful about what they throw away.
The Mulvane Fire Department was called to a vehicle fire Wednesday afternoon. The driver of a trash truck had smelled something burning and pulled over to call 911.
When firefighters arrived, they found smoke coming from the back of the truck. In the trash bay, a firefighter discovered a discarded laptop computer with a lithium battery that was heating up.
The department said it was able to remove the battery from the truck and flood the truck with water to cool off the trash. This is the second incident involving a lithium battery crews have responded to this month, according to Mulvane Fire.
Lithium is highly reactive, and when batteries are damaged, they can heat up uncontrollably. The reaction cascades, with the battery getting hotter and hotter until all of the lithium is consumed. In some cases, when exposed to oxygen, lithium can ignite instantly.
The fire department is urging residents to never throw computers or anything with batteries in the trash. Sedgwick County offers this free recycling guide with information on how to properly dispose of a wide variety of household goods and chemicals.
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KANSAS CITY, Mo. (KCTV) – A power outage is affecting parts of the Kansas City Zoo & Aquarium, leaving some areas and services temporarily limited.
The Zoo announced the outage on Wednesday morning, June 17, saying the webstore and other services may be unavailable while crews work to restore power.
Evergy’s outage map shows the disruption – located near the zoo – is affecting 17 customers. The outage was first reported just before 8:50 a.m. Power is expected to be restored around 10:30 a.m.
The Zoo is asking for the public’s patience as Evergy works to resolve the issue.
The cause of the outage has not yet been identified.
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