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.
When the committee broke for lunch, they went to a popular restaurant across the street from the Statehouse. While there, they spotted staffers from Amerigroup, one of the KanCare managed care organizations (MCOs), treating one of the committee members to a meal.
Meredith Funkhouser, co-owner of Case Management Services Inc., found that frustrating because Amerigroup was the MCO she’d had the most trouble with on the health homes issue.
“Some of those Amerigroup staff members have been contacted by our agency with real problems, and we do not get calls back,” Funkhouser said in an email. “We also rarely get return emails until we have escalated a problem to the oversight committee. … I guess by providing lunch they can explain their way through this debacle over a roast beef sandwich.”
Food and beverages exempt
Lobbyists providing lunch — or other meals — for legislators is common practice in Topeka. Companies and advocacy groups see it as a way to get valuable face time with policymakers so they can make their case on issues that are important to them.
The laws governing such interactions in Kansas are relatively strict compared to other states like Missouri, where legislators may accept unlimited gifts from lobbyists.
In Kansas lobbyists may not give lawmakers any material goods worth more than $40 in a calendar year and they may not spend more than $100 a year per legislator on recreational activities like sporting events.
But food and beverage purchases for lawmakers are exempt from those limits under state law, as long as the lobbyist is dining with the legislator and is not explicitly requesting any legislative action in return.
Marilyn Kubler, director of another case management agency, said when legislators get food and drinks from the MCOs, whose income depends on state Medicaid contracts, those purchases merit scrutiny — especially when the legislators receiving the meals are on the committee tasked with overseeing the MCO’s performance.
“Although it may be legal, it definitely is not ethical and the perception of a state senator or representative being hosted by an MCO for lunches and dinners when they serve on an oversight committee seems like a corruption of office,” Kubler said.
The KanCare committee was established in 2013 to oversee the Medicaid makeover launched that year by Gov. Sam Brownback. KanCare moved most of the state’s Medicaid beneficiaries into health plans run by the three MCOs, which are private insurance companies.
The state’s $3 billion KanCare program serves about 425,000 Kansans.
United Healthcare: $0 for lobbying
The most recent reports published by the Kansas Governmental Ethics Commission outline lobbying expenditures from Jan. 1 to May 27, which includes most of the 2015 legislative session.
Those filings show that the MCOs spent $7,247.44 on lobbying during that period. About $5,325 of that was for 237 itemized meals for legislators and their staff members. The rest were un-itemized expenses, which could include meals for people not directly involved in government, such as legislators’ spouses.
Amerigroup spent $3,121.65. Sunflower State Health Plan spent $1,898.20 and its parent company, St. Louis-based Centene, spent $2,227.59.
The third MCO, United Healthcare, reported no lobbying expenses.
“While we won’t comment on what other health plans may do, we will say that we support all efforts aimed at transparency and hold our meetings during office hours as a way to help make ourselves available to answer questions any policymaker may have,” Molly McMillen, a spokeswoman for United Healthcare, said in an email.
Media relations specialists with Amerigroup and Sunflower did not respond to requests for comment on their lobbying expenses.
Rep. Dan Hawkins, a Wichita Republican who chairs the House Health and Human Services Committee and co-chairs the KanCare oversight committee, was the recipient of the most MCO lobbying meals through May 27.
Hawkins received 41 meals worth $1,061.91 — an average of more than $25 for each meal — during that time from lobbyists for Amerigroup, Centene and Sunflower State.
Hawkins didn’t respond to an emailed request for comment. Previously he’s said that campaign donations from the MCOs do not affect the way he or other members of the oversight committee approach their jobs.
No meals for committee Democrats
The oversight committee is made up of seven Republicans and four Democrats. Rep. John Edmonds of Great Bend was the only Republican on the committee who didn’t receive any meals from the MCOs.
None of the committee’s Democrats received any meals.
Republicans hold large majorities in both chambers. Sen. Laura Kelly, a Democrat from Topeka who is the ranking member of the KanCare oversight committee, said members of her party are often ignored by the MCOs, and that limits policy discussions.
“It’s not that I’m begging for a lunch,” Kelly said. “I don’t care about that stuff. It’s the exclusion of people who are from a different party or who might disagree with you. People who might ask you challenging questions.”
Kelly also is ranking minority member of the Senate Public Health and Welfare Committee. Amerigroup is co-hosting a fundraiser next month for the re-election campaigns of the committee’s seven Republicans.
Kelly said lobbyists have always gravitated toward the party in power, but in the last several years the partisanship has gone “to another level.”
“It just feels different now,” she said.
Andy Marso is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.
