TOPEKA — KanCare plan assignments could start going out to the state's Medicaid enrollees by early next month, but no sooner, according to state health officials.

"We're starting the process for initial member assignment, but it takes a little bit to do that," said Kari Bruffett, direct of the Health Care Finance Division at the Kansas Department of Health and Environment. "We'll make a public statement when those packets do start to mail...the earliest would be early November when packets would be received."

Earlier this month, state officials said there was a possibility the assignments might go out by the end of October. If KanCare goes as planned by administration officials, it will be launched on Jan. 1.

Officials say they would rely on a computer software program to "auto assign" each Medicaid enrollee to one of the three coverage plans, so that each plan has a roughly equal number of participants. The enrollees then would have at least until mid February 2013 to choose one of the other two plans, if that was their preference.

The state has about 380,000 Medicaid beneficiaries, so each plan would have about 125,000 members, at least initially.

Total cost of the Kansas Medicaid program next year is expected to be about $3.2 billion. The federal government picks up about 57 percent of that cost and Kansas taxpayers cover the rest.

Bruffett's comment came Wednesday during the administration's weekly teleconference with potential KanCare service providers.

During the conference call, Bruffett also talked briefly about the meeting last Thursday that she and other top Kansas health officials had last week with federal officials in Baltimore to discuss the state's application for a so-called Section 1115 waiver, seeking approval for the changes Gov. Sam Brownback's KanCare proposal would bring to the state's Medicaid program.

"It was a great meeting," she said. "It went from 9 a.m. until after 5 p.m. We just had a good long day with them and worked through a lot of issues. As a result, we're still moving forward with an eye toward Jan. 1."

KanCare would shift virtually all the state's Medicaid beneficiaries, including the elderly in nursing homes and the mentally ill, into managed care plans run by three private insurance companies. It would be the biggest single set of changes to the state program since it was inaugurated in the 1960s, according to those familiar with the program's history.

Bruffett said there was "no timeline" for the federal decision on the 1115 request, but that "the state and CMS are committed to a smooth transition."

Representatives of Sunflower State Health Plan, Amerigroup and United Healthcare, the KanCare managed care companies, each said their companies were making progress in hiring and training employees and in signing doctors, hospitals and other providers to their respective provider networks. State officials have said their goal is to ultimately have every Medicaid provider signed with at least one of the networks.

But some teleconference participants indicated they wouldn't be signing contracts until they had a chance to review final versions of the companies' respective provider manuals, which are referenced extensively in the proposed contracts.

"Most hospitals are probably taking the position we are - not signing until we get the provider manual," said Kevin Miller, chief executive of Hutchinson Regional Medical Center.

Only one of the three insurance companies, Sunflower, has issued a final manual. The other two companies' documents still are being reviewed by Kansas officials to assure they comply with the state's expectations, Bruffett said.

She said those finalized manuals would be released "soon."

Sunflower is a subsidiary of Centene, which is headquartered in suburban St. Louis, Mo.