KanCare

Andy Marso / Heartland Health Monitor

Kansas tax collections for May fell short of projections by about $74 million, and legislators said Wednesday they fear that will mean more cuts to Medicaid.

The May shortfall comes despite the state’s revenue estimating group revising projections downward for the third consecutive time about six weeks ago.

It wipes out the meager savings Gov. Sam Brownback created when he made cuts two weeks ago after the Legislature sent him a budget that didn’t balance.

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Kansas health care providers will urge federal officials to reject Gov. Sam Brownback’s proposed Medicaid cuts and may challenge them in court.

The recently announced cuts would reduce state expenditures for KanCare, the state’s privatized Medicaid program, by $56.3 million and trigger a loss of approximately $72.3 million in federal funds. Combined, the managed care organizations that administer $3 billion KanCare program and the health care and service providers they have contracts with would be forced to absorb more than $128 million in cuts.

Bryan Thompson / Heartland Health Monitor

State officials on Thursday wrapped up a series of public forums on the pending renewal of KanCare, the state’s privatized Medicaid program.

Federal approval for the five-year demonstration project expires at the end of 2017, and the Kansas Department of Health and Environment plans to apply for reauthorization by the end of this year.

Forum organizers were looking for ideas about coordination of care, value-based payment systems and waiver integration.

Andy Marso / Heartland Health Monitor

A proposal to reimburse some KanCare providers at a higher level based on patient outcomes drew skepticism from a crowd of hundreds who gathered Tuesday afternoon in a Topeka hotel ballroom.

Tuesday’s public meeting was the first in a series that state officials are hosting as they prepare to renew their federal application for KanCare, the state’s $3 billion managed care program that privatized all Medicaid services under three insurance companies in 2013.

Similar gatherings are scheduled Wednesday in Kansas City, Kan., and Wichita and Thursday in Pittsburg and Hays.

File photo / Heartland Health Monitor

This story was updated at 8:30 p.m.

Gov. Sam Brownback trimmed more than $56 million from Medicaid in Kansas as part of larger budget cuts announced Wednesday, raising concerns that health care providers may decide not to take unprofitable patients.

About $38.2 million of the $56.4 million in budget cuts comes from reducing reimbursements by 4 percent for providers who treat patients covered by KanCare, the state’s privatized Medicaid program launched in 2013. The remaining $18.2 million comes from cuts in other areas of the Medicaid program.

State officials have scheduled five meetings to gather public comment on KanCare in advance of renewing contracts to administer the state’s privatized Medicaid program.

The contracts currently held by UnitedHealthcare, Amerigroup and Sunflower State Health Plan (a subsidiary of Centene) expire in 2018. Those private insurance companies serve as managed care organizations that operate KanCare.

Susan Mosier, secretary of the Kansas Department of Health and Environment, said her agency wants to hear from the public on what to include in the next contracts.

Courtesy Bill Stovall

A statewide registry is in the works to make it easier for Medicaid patients to find qualified, reliable personal care workers.

That’s good news for Bill Stovall of Topeka and others like him who help direct care for their family members.

Stovall has a long list of complaints against personal care workers who have cared for his sister in recent years, including punctuality problems and a lack of training.

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Federal officials are concerned about a growing backlog of Kansas Medicaid applications and have asked state leaders to provide regular updates about what they're doing to fix the problem.

James Scott, associate regional administrator for the federal Centers for Medicare and Medicaid Services sent a letter to Kansas Department of Health and Environment officials Feb 17, citing concerns about “recent reports" of the Medicaid application backlog in the state of Kansas.”

Scott asked KDHE to submit within 14 days a plan to correct the backlog.

Andy Marso / Heartland Health Monitor

Judy Kregar is not a member of the Rotary Club in nearby Greensburg, but she decided to go when she heard Gov. Sam Brownback would be at the club’s recent meeting.

Kregar, the administrator of a small nursing home in nearby Bucklin, wanted to tell Brownback in person about the struggles some of her residents are having getting their Medicaid applications and annual renewals processed.

 Kansas is seeking a renewal of the Medicaid waiver for its KanCare program. As the federal government decides whether to grant the waiver, we discuss  future ideas to streamline the program and how well it provides healthcare for the most vulnerable Kansans. 

Guests:

  • Tim Wood is director of the Community Developmental Disabilities Organization for Johnson County.
  • Kari Bruffett is the policy director for the Kansas Health Institute.
  • Dan Margolies is KCUR's Health Editor.
Andy Marso / Heartland Health Monitor

The state’s $3 billion privatized Medicaid system has been without an inspector general for more than a year. The Kansas Senate unanimously approved a bill Wednesday that would eliminate the position.

Andy Marso / Heartland Health Monitor

Thousands of Kansans seeking Medicaid benefits are being forced to wait months because of continuing problems with a new computer system and a change in the state agency responsible for handling some eligibility determinations.

Jim McLean / Heartland Health Monitor

Officials from Lawrence Memorial Hospital returned Friday to the Statehouse armed with details about ongoing problems they’re having with the companies that manage KanCare, the state’s privatized Medicaid program.

A panel of legislators Friday reversed their recommendation of a lifetime ban on hepatitis C drugs for Medicaid patients who don’t comply with their treatment regimen.

Members of the Joint Committee on Home and Community Based Services and KanCare Oversight walked back on the recommendation they made in December  after hearing from Mike Randol, who heads the Kansas Department of Health and Environment’s Division of Health Care Finance.

KHI News Service

A key member of Gov. Sam Brownback’s new rural health working group says he hopes the initiative is a serious effort to address problems facing rural providers, not an attempt to divert attention from a renewed push to expand the state’s Medicaid program.

Republican Rep. Jim Kelly represents Independence, the southeast Kansas community that recently lost its only hospital due to budget problems exacerbated by federal reductions in Medicare reimbursement rates and the state’s rejection of Medicaid expansion.

Jim McLean / Heartland Health Monitor

A tentative plan to save Kansas government more than $2 billion over five years relies heavily on proposed changes to the state employee health plan and Medicaid.

The report, written by the New York-based consulting firm of Alvarez and Marsal under a $2.6 million contract with the state, includes 105 recommendations for “achieving major cost savings.”

Mike Sherry / Heartland Health Monitor

If policy makers in deep-red Indiana can do it, so can their equally conservative counterparts in Kansas.

That was the dominant – though not unanimously held – message at a forum Tuesday at Johnson County Community College, where the topic was expanding the Kansas Medicaid program to cover as many as 150,000 additional Kansans.

File photo / Heartland Health Monitor

A legislative oversight committee has approved a controversial set of draft recommendations aimed at reducing the cost of drugs provided to Kansas Medicaid recipients.

The joint committee that oversees the state’s privatized Medicaid program known as KanCare this week tentatively approved recommendations that direct the Kansas Department of Health and Environment to develop policies aimed at slowing a steady increase in the $3 billion program’s pharmacy costs.

One of the three companies that administer KanCare co-hosted a fundraiser Wednesday for Republican members of the Senate Public Health and Welfare Committee, opening a new chapter in the state’s move to privatized Medicaid.

The three managed care organizations the state contracted with in 2012 receive nearly all their revenue in Kansas from state and federal tax dollars.

One of the companies, Amerigroup, on Wednesday used some of that revenue to bolster the re-election campaigns of Republicans who control a committee charged with overseeing its performance.

Andy Marso / Heartland Health Monitor

A group of case managers from Johnson County who work with Kansans with disabilities came to Topeka last month to air grievances about the state’s “health homes” initiative.

In the morning, several of them testified in front of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.

Jillisa Washington

The Kansas Department for Aging and Disability Services is reviewing a waiting list for developmental disability services after counties reported discrepancies between how many residents they have waiting and how many are on the state’s list.

There are more than 3,000 Kansans with intellectual and developmental disabilities (I/DD) on the KDADS waiting list for Medicaid-covered support services meant to allow them to remain in their homes and communities rather than live in institutions.

Advocates Take Aim At KanCare Grievance Process

Aug 20, 2015
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  Each month, according to the latest available data, roughly 225 KanCare beneficiaries file complaints about the care they’ve received or been denied. That’s a small percentage, considering that more than 400,000 Kansans depend on the state’s privatized Medicaid program.

The numbers also show that all but a handful of the complaints are resolved within 15 days.

State officials often cite the data when assuring legislators that KanCare, now in its third year, is meeting the needs of its beneficiaries.

Andy Marso/KHI News

  Lt. Gov. Jeff Colyer was on hand Thursday for the unveiling of a book to educate children about interacting with people who have disabilities.

“Darby Boingg Has an Adventure and Meets a Person with Disabilities” features Boingg, a wallaby with human characteristics, who meets Ian, a young man in a motorized wheelchair.

Sunflower State Health Plan hosted the book signing at the Topeka and Shawnee County Public Library. The event featured  author Michelle Bain and Ian Kuenzi, a Topekan with cerebral palsy who was her inspiration.

A federal whistleblower lawsuit alleging that one of the companies running KanCare ordered employees to shift KanCare members away from high-cost health care providers has been dismissed.

A one-sentence document filed Tuesday in federal court in Kansas City, Kansas, said that the plaintiff, Jacqueline Leary, and the defendants, Sunflower State Health Plan Inc., its parent company Centene Corp. and three other parties, had stipulated to the dismissal. Each party was to bear its own costs and attorneys’ fees.

Andy Marso / Heartland Health Monitor

A year ago there were almost 3,500 Kansans with physical disabilities awaiting Medicaid coverage for services to help them live in their homes and communities.

Much has changed in 12 months. The physical disability (PD) waiting list is down to fewer than 1,500 people, and Kari Bruffett, secretary of the Kansas Department for Aging and Disability Services, told members of the National Council on Disability who visited Topeka earlier this month that more reductions are coming.

The three companies that administer KanCare have donated more than $50,000 to the campaigns of current Kansas legislators since the $3 billion Medicaid program began in 2013.

Amerigroup leads the trio with $27,750 in donations, as of the most recent filings, which include donations through Dec. 31, 2014. Centene Management Corporation, the parent company of Sunflower State Health Plan, gave $17,250 in that time period. United for Health, the political action committee of United HealthCare, came in a distant third with $6,200 in campaign cash.

Jim McLean / Heartland Health Monitor

Kansans with disabilities make up about one-fourth of KanCare, the state’s managed care Medicaid model.

But they’re a vocal segment, and they and their advocates painted a picture Tuesday of a system struggling to provide them with the long-term supports they need to stay in their homes and communities rather than institutions.

Andy Marso / Heartland Health Monitor

Andrea Duarte-Rambo, a short, dark-haired woman from Johnson County, walked to the podium and commanded the attention of a full legislative hearing room as she began talking about her son’s traumatic brain injury.

Her son’s brothers hid the injury for fear of getting in trouble, Duarte-Rambo said. His undiagnosed condition led to unexplained mood swings and violent behavior, multiple inconclusive MRIs, treatment with antipsychotic medications that actually worsened his symptoms and a couple of trips to jail.

A federal judge has thrown out Centene Corp.’s abuse-of-process claim against a former employee who alleged she was fired after complaining about the managed care company’s business practices. 

Centene is the parent company of Sunflower State Health Plan Inc., one of three for-profit companies managing KanCare, Kansas’ privatized version of Medicaid.

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More than 389,000 Kansans and nearly 2 million Missourians were affected by last month’s massive cyberattack on Anthem Inc., the nation’s second largest health insurer, figures released by the company show.

“This data breach is so far-reaching that it impacts nearly one-third of our state’s population,” Missouri Department of Insurance Director John M. Huff said in a statement Monday.

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