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More denial of Medicaid claims seen by hospitals BY KELSEY RYAN AND DION LEFLER The Wichita Eagle

Since the state turned Medicaid over to private insurers in January, it’s the hospitals that have been in pain. Executives at Wichita’s two big hospital systems say they have seen huge spikes in the number of Medicaid claims denied by the three companies that manage care for much of the state’s poor and disabled populations. Having to appeal those denials has delayed payments and increased administrative red tape for the hospitals – the opposite of what was promised when Gov. Sam Brownback shifted the system from government to largely private control. “It’s clearly created significant financial pressures on us in 2013, and we’re questioning what

Jaime Green/The Wichita Eagle

Bond renovations to North High include a new gym, pool, wrestling room, outdoor athletic facilities, auditorium upgrades, other renovations. In 2008, voters approved a $370 million bond issue in the Wichita school district.


School bond benefits local firms

Please see CLAIMS, Page 13A


Nearly five years after Wichita voters approved a recordsetting $370 million school bond issue, local architects and contractors are reaping the benefits. Eighteen architecture firms and 17 construction companies have landed work as part of the school bond issue, records show. The Eagle recently filed a request under the Kansas Open Records Act for information about money paid to contractors and architecture firms as part of work related to the 2008 bond issue. Of the nearly $228 million paid through Sept. 5 for 70 projects, about $153 million – more than two-thirds – went to four architecture firms and five contractors, which designed and built several new schools or multi-

Health law divides 2016 GOP hopefuls



For a breakdown of what each company has been paid, and the projects they’ve worked on, see Page 14A.

Fernando Salazar/The Wichita Eagle

Students participate in a balloon launch to celebrate their new multi-purpose room, which was paid for with school bonds, at Chisholm Trail Elementary in Park City on Friday.

million-dollar additions to existing buildings. Among architects, Schaefer Johnson Cox Frey received the largest payout – more than $4 million in architec-

ture fees and another $3 million for overseeing the bond. Next were Spangenberg Phillips Tice and GLMV Architecture, each with nearly $1.7 million, and Howard & Hel-

mer Architects, with about $1.5 million. Among contractors, the Law Co. received the most bond money – about $38 million – for building the new Northeast Magnet High School and the new Mueller Elementary. Next were Dondlinger & Sons, with nearly $30 million; Coonrod & Associates, $25.8 million; Walz Harman Huffman, $25.3 million; and National Contractors, $22.5 million. Some of those firms made some of the largest contributions to a group that


A clear divide over the health care law separates the emerging field of potential GOP candidates for the 2016 presidential race, previewing the battles ahead as they try to rebuild the Republican party and seize the White House. U.S. Sen. Ted Cruz says he will fight “with every breath” to stop President Obama’s signature domestic achievement, even if that means shutting down parts of the federal government. It’s an approach that former Florida Gov. Jeb Bush calls “quite dicey” politically for Republicans. Allied on one side are Cruz, U.S. Sen. Marco

Please see SCHOOLS, Page 14A

Please see GOP, Page 6A

that wrapped up Saturday night in Wichita: A young navigator from Ohio promises he will become a priest if he makes it back from the war alive. An 18-year-old Texan who lost his leg faces the struggles of war’s aftermath. A gunner returning to Hickam Field after the early morning bombing of Pearl Harbor is fired upon by U.S. ships. Ten of the 130 known living WWII

Marion Unruh, an Army Air Corps pilot from Pretty Prairie, with his “Pretty Prairie Special” B-24 bomber in 1943 on Guadalcanal. He later became commander of the Fifth Bombardment Group and a prisoner of war after being shot down on Dec. 30, 1948.

Please see REUNION, Page 12A

Courtesy photo


BY RICK PLUMLEE The Wichita Eagle

Before World War II pilot Marion Unruh returned to duty in the South Pacific in the summer of 1943, he said goodbye one last time to his hometown of Pretty Prairie. He flew his B-24 heavy bomber low along the town’s Main Street and rocked his wings. About five months later, on Dec. 30, 1943, his plane was shot down near New

©2013 The Wichita Eagle and Beacon Publishing Co., 825 E. Douglas, Wichita, KS 67202.

Guinea, and he was taken prisoner by the Japanese. A colonel in the Army Air Corps’ Fifth Bombardment Group, Unruh was released shortly after the Japanese surrendered in August 1945. As the top ranking officer among the prisoners, Unruh was presented a Japanese flag and sword – the same sword used to behead American prisoners – by the prison’s commander. Unruh’s story and many more were shared when about 100 people attended the Fifth Bomb Group’s four-day reunion

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Families hear WWII vets’ stories at reunion

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WWII soldier’s letter finally reaches daughter about him since her mother could rarely bring herself to RENO, Nev. – A World War discuss the love of her life. “The letter gave me more II soldier’s heartfelt letter to knowledge of who he was,” his daughter has finally she said. “He poured out his reached her, seven decades heart to me, and a lot of men after it was written. don’t put that kind of emotion Peggy Eddington-Smith received the letter penned by in writing. I’m just overwhelmed by everything, tryher father, Pfc. John Eddington, as well as his Bronze Star ing to absorb everything.” Donna Gregory of St. Louis and Purple Heart medals, found the soldier’s letter and during an emotional cereother World War II memormony Saturday in Dayton, abilia in a box 14 years ago Nev., about 40 miles southwhile helping her then-huseast of Reno. band clean out his grandparThe father she never met ents’ home in Arnold, Mo., a wrote the three-page letter shortly after she was born and St. Louis suburb. Gregory’s voice cracked shortly before he died in Italy in June 1944. He sent it while with emotion as she read the stationed in Texas, just before letter Saturday, bringing tears to Eddington-Smith and many he was sent overseas. Getting his medals was nice, in the crowd of about 150. The soldier devoted the first but the letter meant more because it made her feel clos- page to his wife, saying he hoped she did not find it “siler to her father, Eddingtonly” that he was writing a letter Smith said. She knew little Associated Press

Associated Press /

This photo provided by Donna Gregory shows the Purple Heart awarded to Pfc. John Farrell Eddington.

to a child who could not read. Addressing the next two pages to his “darling” daughter, he wrote that while she may not see him “for some time,” he wanted her to know that she was always on his mind.

“I love you so much,” the letter says. “Your mother and daddy … are going to give you everything we can. We will always give you all the love we have.” Eddington urged his daughter to “always treat your mother right. You have the sweetest mother on the Earth.” He closed the letter by writing, “I love you with all my heart and soul forever and forever. Your loving daddy.” Eddington-Smith and Gregory are unsure what connection the soldier had to the couple who owned the house where his memorabilia was found. Eddington was from Leadwood, Mo., about 75 miles southwest of St. Louis. Gregory tracked down Smith in June after a search that involved libraries and the Internet. Both women cried during their initial phone

Kevin Clifford/Associated Press

Peggy Eddington-Smith, of Dayton, Nev., receives a reproduction copy of her father's dog tags during a ceremony Saturday.

conversation that left the daughter shocked by the items’ discovery. Eddington-Smith knew her father died in the war. She was unaware of the letter and

other contents of the box, including 16 letters from Eddington to his mother, his draft card and military dog tags, his high school diploma and newspaper clips.

tals and professionals provide to our Kansas members and we will continue make strengthened provider experience and relationships a top priority.”

and eats up staff time, she increase in uninsured and an primary care access, for the said. increase in charity cases.” first six months we haven’t One of the issues is that the Tappan said he remains seen that on the hospital managed care companies are hopeful. side,” Leary said. “And then From Page 1A “I am choosing to believe at not subject to Kansas’ prompt on top of that, we continue to payment laws, Samuelson this point that (the problem) see a significant amount of said, which generally require is primarily moving to three uninsured.” our financial position will managed care companies and payment of health insurance So-called “charity” emerlook like later in 2013 and ER visits the speed at which we tried to claims in 30 days. gency room cases, where the 2014,” said Hugh Tappan, However, Kari Bruffett, push three managed care chief executive at Wesley Hospital officials hoped that hospital provides free or disKDHE director of health care companies,” he said. counted care to low-income Medical Center in Wichita. KanCare would create more Hugh Tappan, CEO, medical homes, where Med“I choose to believe that we finance, said the companies people who can’t qualify for “We take care of a subWesley Medical Center icaid recipients would see a have an incentive to promptly will see this ultimately reMedicaid, have gone from stantial number of the Medpay claims because 3 percent 250 last year to 659 so far this solved, but our short-term icaid and uninsured in our primary care provider more experience is that the hospital of the state’s payments to the year, Leary said. community. But we have to often and seek more prevencompanies are withheld unhas been disadvantaged Health care providers say have a flow of revenue we can back and Lt. Gov. Jeff Colyer, tive care, avoiding costly trips a doctor, held a Capitol news less they pay out “clean through KanCare.” increased use of emergency anticipate and make sure to emergency rooms. conference to announce they claims” within 20 days, acrooms often leads to higher expenses can be adjusted But Tappan said that isn’t are shifting $37 million from cording to the company concosts of care for everyone. accordingly. It creates some happening. Incentive to pay KanCare savings to provide tracts with the state. The transition has also led sustainability questions.” The hospital is seeing inpromptly Those withholdings are only to an increase in adminisVia Christi Health, Wichita’s home- and community-based creased emergency room services to 650 people – 400 visits for those who qualify for trative overhead, including paid to the companies at the Samuelson, of the Kansas largest hospital network, is with physical disabilities and end of the year, so it’s too filing of claims, and the med- Hospital Association, has reporting similar problems. Medicaid, he said – more 250 with mental disabilities early for estimates on what created an advisory group ical center has added about Cindy Samuelson, of the than 15,800 total since Kan– who have been on waiting Care began. with its members and officials the companies will receive, 20 full-time employees beKansas Hospital Association, lists. Bruffett said. of KDHE and insurance comcause of it, Tappan said. said similar complaints have Tappan and Leary said that Rep. Jim Ward, D-Wichita, “When you consider the panies to focus on systemic “We do believe that Kanbeen coming in from hospitals shows that patients aren’t is a member of a new legislaextent of the contracts overissues. Care can work, but today statewide. accessing primary care proall, it’s a considerable in“The KDHE has been rewe’re not seeing the behavior“This is not just in one pock- tive committee appointed to viders for smaller ailments oversee the implementation centive for them to process sponsive and the MCOs (inet of the state,” she said. and instead are coming to the al transitions, the medical of KanCare. He attended a those claims promptly,” Brufhome placement that KanCare surance companies) in some Officials of the Kansas Deemergency room. fett said. cases have not been as repromised,” Tappan said. partment of Health and Envi- recent presentation by Tappan “So any effort to think that at Wesley and said he’ll bring KanCare was going to help sponsive” to the complaints, “What we are seeing is an ronment, who oversee the up the hospital’s complaints she said. The delay in payincrease in Medicaid volume Reach Kelsey Ryan at 316-269-6752 privatized Medicaid program move people out of the ER when the committee holds its into medical homes, more ments causes cash flow issues or in our ER. We’re seeing an called KanCare, have consisfirst meeting Oct. 8. tently labeled problems as But he said he’s concerned growing pains and said they’re working to solve them. because the committee has “I understand that providers been scheduled to meet for only two days. are frustrated by transitional “I hope we don’t just have issues that remain,” KDHE the dog-and-pony show from Secretary Robert Moser said the (Brownback) adminisin an e-mail. “KDHE remains tration,” he said. “I saw the focused on solutions, and we lieutenant governor’s been have directed the plans to going around saying impletake a more proactive role in mentation has gone better engaging providers in the process of resolving outstand- than expected. I guess not if you’re a hospital or doctor or ing issues.” one of the other providers.” But Matt Leary, Wesley’s He said he’s not surprised chief financial officer, said the by the complaints since it’s to number of denials and the dollars involved have risen as managed care organizations’ advantage to deny and delay the year has gone on. “There was very little activ- payments. “Managed care HMOs ity for the first couple of (health maintenance orgamonths, but the past three nizations) in the ’80s and ’90s months, we’ve averaged apdid the same thing,” he said. proximately 400-plus thouRep. David Crum, R-Augussand dollars a month in denials,” he said. “So far, year to ta and co-chairman of the oversight committee, also date, the KanCare providers attended Tappan’s presentacollectively have denied $1.6 tion and said he has been million of our charges hearing mixed reviews. through July.” “There are those who are The dollar figure represents concerned about denials on denied charges for 560 paclaims and slow payments, tients, Leary said. but then also a lot of the same “The same period last year, through traditional Medicaid, folks who tell me that say they’re working through the we only had 263,” he said. Via Christi declined to share issues and they feel very optimistic that those issues are specific numbers, but David going to be resolved,” he said. Hadley, its chief financial He said he plans to ask the officer, said since the begincommittee chairwoman, Sen. ning of the year, the hospital Mary Pilcher-Cook, R-Shawsystem has seen a nearly 48 nee, to put the issue on the percent increase in Medicaid claim payments more than 90 agenda for the Oct. 8 meeting. days in arrears. “I think what folks have to “So despite the ongoing understand is that this is a communications and efforts huge, monumental change in being made by all parties, it the way we’re doing business continues to be a struggle to and we’re a little over six get timely and accurate payments for Medicaid accounts,” months into the program,” Crum said. “We obviously Hadley said. The right care means you can still participate in the things you love, have to make sure these iswhether it’s cards with the girls, or your grandson’s baseball game. sues are resolved. I don’t ‘Monumental change’ know that it’s totally surpris2>"!3 (3 =8:%@ )+9 7580>'% )8:7+9>894!>7& 35+947853+3>89& )890%54+3>89& !%;7 A +4 :1)!& 85 KanCare is designed to save ing that we’re going through money for the state by paying some of these growing pains.” +4 ;>33;%& +4 .81 /+936 -% 7580>'% + )1438: )+5% 7;+9 #85 %+)! );>%93& +9' :+3)! 3!% )+5%">0%5 KanCare is run by three three managed care insurance *+4%' 89 4<>;; 9%%'%'& >93%5%434 +9' 7%5489+;>3.6 ,81 )+9 43>;; '8 /!+3 .81 /+93& /!%9 .81 managed care organizations: companies a capped rate per Amerigroup, UnitedHealthcovered consumer, rather /+93& />3! 3!% 5>"!3 )+5%6 ?85 + #5%% >9$!8:% )+5% +44%44:%93 )+;; 14 38'+. +3 #%'&!#%&'"$$6 than having state government care and Sunflower State pay the hospitals, doctors and Health Plan, a subsidiary of The Right Care, Right at Home. other service providers direct- Centene. Spokespersons for all three ly. Medicaid is jointly funded companies declined requests by federal and state dollars. About 320,000 Kansans are for interviews and data and referred questions to the covered by KanCare. The Right at Home state. program covers low-income United sent a statement children, their parents, preg7348 West 21st, Suite 101 saying: “We are committed to nant women, people with Wichita, KS 67205 working closely with our disabilities and some seniors in conjunction with Medicare. enrollees and providers Phone: 316-531-6477 through our advocacy teams While hospitals struggle and transparency tools.” under the new system, the And Amerigroup sent one state government has been saying it values “the care and seeing savings. services our network of hospiLast week, Moser, Brown-


“I choose to believe that we will see this ultimately resolved, but our short-term experience is that the hospital has been disadvantaged through KanCare.”

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One story in this entry - "More denial of Medicaid claims seen by hospitals" by Kelsey Ryan and Dion Lefler

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