Medicaid call-in center to stay open after all

Budget cuts threatened shut down of the service important to doctors and others

0 | KHPA, Medicaid-CHIP

— A toll-free help line for Medicaid clients and their medical providers that was slated to be dismantled due to budget pressures will remain open, officials announced today.

HP Enterprise Services, the contractor that processes Medicaid claims for the state, has agreed to accept reduced rates for providing customer service calls in exchange for having its annual contract with the state extended to 2013 with options to extend again in 2014 and 2015.

The Kansas Health Policy Authority announced in November it intended to cease call-center operations in response to budget cuts ordered by Gov. Mark Parkinson. Shutting down the call center was expected to save the agency about $250,000 of the $1.1 million it was ordered to trim from its operating budget.

The call center receives about 250,000 calls a year and news it was closing sparked concern among doctors, pharmacists and other providers who use it to help resolve billing questions and other matters.

Legislators criticized agency officials for not finding other ways to cut their budget, saying that eliminating the call center would end up costing the state more because providers would resubmit claims until they got them right leading to higher administrative costs for the agency and the providers.

Health policy authority officials said today that after they gave HP Enterprises notice of their intentions, the company approached them with an alternative plan:

  • HP has agreed to accept a 10 percent cut in the fixed monthly price it is paid for each enrollee in Medicaid and the Children’s Health Insurance Program and a 5 percent reduction in the fixed price paid for each claim processed. The fixed price per claim is now .69806 cents instead of .7348 cents. The fixed price per Medicaid enrollee per month is now $3.67641 instead of $4.0849. The fixed price per CHIP enrollee per month is now$4.16349 instead of $4.6261.
  • In exchange, KHPA agreed to extend HP’s contract for two years, from 2011 to 2013, and has added two additional one-year extension options for 2014 and 2015.

“This call center is vitally important, both to the health care providers who serve Medicaid patients as well as Medicaid beneficiaries,” said Acting Medicaid Director Barb Langner in a prepared statement. “Just as one example, when a pharmacist has a patient at the counter who’s trying to get a prescription filled and for whatever reason the claim doesn’t go through, that situation needs to get resolved right away. You don’t want to send that person home without their medications.”

HP Enterprise Services was formerly known as EDS. The firm's contract with the health policy authority is worth about $34 million a year.