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Nov. 8, 2012
TOPEKA With KanCare's scheduled launch only short weeks away, spokesmen for groups representing the elderly and developmentally disabled today urged legislators to delay Gov. Sam Brownback's Medicaid makeover plan for at least six months.
"We believe such an aggressive timeline, with little oversight, for an untested system will place many of the state's frailest and most vulnerable residents into a long-term managed care program that we believe the state is not ready to operate," said David Wilson, testifying on behalf of AARP Kansas to the Joint Committee on Home and Community Based Services Oversight.
KanCare is scheduled to begin Jan. 1, pending needed federal approvals. But Wilson said AARP would like to see the program held until six months after federal officials OK the state's Medicaid waiver application to assure oversight and infrastructure are in place for the changes.
It remains unclear when or if that waiver approval will come, though Brownback officials told the legislative panel they were optimistic they would have it by Jan. 1 and were proceeding accordingly based upon ongoing talks they are holding with officials at the federal Centers for Medicare and Medicaid Services.
Matt Fletcher of Interhab, a group that represents most of the state's Community Developmental Disability Organizations, said "a six-month delay would greatly improve the prospect for positive outcomes from this sweeping overhaul of Medicaid."
Lobbyists for the state's two nursing home associations told lawmakers their members were "nervous" and "frustrated" about KanCare and concerned about lack of details how it will work, but they did not call for postponement.
Administration officials said they saw no reason for delay.
Kari Bruffett, director of the Division of Health Care Finance at the Kansas Department of Health and Environment, said readiness reviews of the three KanCare managed care companies completed in mid-October had shown that the companies met the benchmarks to proceed on schedule.
She said notices to the state's 380,000 Medicaid beneficiaries of their KanCare plan assignments would start going out immediately and that by the end of the month all the notices will have been mailed.
She also said that the companies had until Nov. 16 to demonstrate that each had developed adequate provider networks.
All provider manuals from each of the companies have been or will be approved effective this week, she said. Many providers have said they would not sign contracts with the companies until they had those manuals in hand.
Bruffett also told legislators that federal officials were well aware that the administration was proceeding with the intention of launching KanCare on Jan. 1 and had not signaled opposition.
"Until the ink is dry, we won't have approval from them," she said, but described the discussions between state and federal officials as "very positive."
"We'll definitely let you know, if we hear otherwise," Bruffett told committee members.
She said state officials had agreed to alter their waiver application based upon the talks. Among the changes was dropping a request that KanCare enrollees only be allowed 45 days to choose a different plan after being auto-assigned to one on the basis of a state algorithm designed to match them with their main medical provider. Instead, enrolles will have 90 days to switch plans.
She said the state also would delay KanCare "employment-related" pilot programs until at least a couple of months after the launch and would assure that state employees review at least a certain percentage of care plans developed by the KanCare companies for their enrollees. She said the state also would have a KanCare ombudsman to handle customer and provider complaints as a result of federal input.
In other action Thursday:
The committee heard testimony from various groups in favor of creating a new legislative oversight committee to review the KanCare program.
Received an update on the status of the waiting list for home and community-based Medicaid services for persons with physical disabilities from Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services.
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