Health
8:06 am
Thu January 23, 2014

Green Light Expected Soon On Second Phase Of KanCare

People with developmental disabilities gather along with advocates and caretakers at a pre-implementation meeting in Wichita in June 2012.
People with developmental disabilities gather along with advocates and caretakers at a pre-implementation meeting in Wichita in June 2012.
Credit Bryan Thompson / Kansas Public Radio

A federal Medicaid official says Kansas is making "substantial progress" toward a major expansion of the Medicaid privatization program known as KanCare.

During a statewide teleconference Wednesday, Kansas officials said the federal Centers for Medicare and Medicaid Services (CMS) is on the verge of approving the state’s plan to move residents with intellectual and developmental disabilities to the program. It would put residential, employment, and independent living services under the control of the private insurance companies that run KanCare.

“We do believe we have made significant progress with the state around the amendment they’ve proposed to include long-term services and supports within the managed care framework that Kansas has implemented for individuals who have intellectual and developmental disabilities,” said Barbara Edwards, who directs elderly and disabled health programs at CMS

Those supports include services like personal care attendants, who make it possible for many people with disabilities to live in their own homes, rather than institutions. They also include transportation, and supports many recipients need to be able to hold down a job.

Gov. Sam Brownback wanted to include those services when KanCare began a year ago. However, a one year delay was granted in response to protests from Kansans with disabilities, along with their families, guardians, and service providers. Their concerns have not been entirely resolved yet.

Del Richardson identified herself as the parent of a son with developmental disabilities. She told the 450 people on the call that KanCare is not ready to provide the daily needs for kids like her son

“Because our kids are not primarily sick, their daily needs cannot be met by a medical service manager," Richardson said. "So far, the experience that our people have had who have already been enrolled in KanCare is that the managers are rather naïve, and they’re unskilled in the daily needs of our young people.”

Providers of disability services also expressed concerns about KanCare. Deb Voth with Rainbows United in Wichita says 46 percent of the autism-related claims submitted by her agency for payment are denied by the KanCare organizations.

One of the three companies has denied more than 90 percent of those claims, according to Voth. She says KanCare has not performed as advertised.

“It’s been nothing but frustrating and heart-breaking for many across the state, and when rhetoric is believed over actual experiences by consumers, families, and providers," said Voth.

Kari Bruffett, who’s in charge of health care financing at KDHE, says the ongoing problems with claims payment are gradually being resolved.

“We have seen a great increase in the accuracy and timeliness of processing of claims. Denial rates are very comparable to where they were pre-KanCare," said Bruffett. "However, we know that that isn’t always necessarily a uniform experience with all providers.”

State officials have proposed several new contract provisions aimed at addressing any concerns that might cause federal Medicaid officials to balk at adding long-term services and supports for more than 8,000 Kansans with disabilities to the KanCare contracts.

Barbara Edwards, from CMS, didn’t say how soon a decision might be handed down, but she seemed to indicate that the process is nearing its end.

“We think that this opportunity to hear the discussion between the state and stakeholders with regard to the protections that are being proposed and the actions that have been taken to assure a successful program in Kansas is an important part of our process as we finalize our work with the state," she said.

State officials think a decision on the expansion of KanCare could come down from Washington as early as Feb. 1.

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