Federal officials likely to approve KanCare plan, KDHE official says

0 | KanCare, Medicaid-CHIP

— A top official at the Kansas Department of Health and Environment today assured a legislative panel that efforts to secure federal approval for Gov. Sam Brownback’s plan for privatizing almost all of the state’s Medicaid programs appear to be going well.

“I don’t see it being rejected,” said Kari Bruffett, KDHE’s director of health care finance, testifying before the Joint Committee on Home and Community Based Services Oversight.

Brownback’s plan for remaking the state’s Medicaid program is called Kancare.

Bruffett said she and other KanCare officials have been in weekly discussions with Centers for Medicare and Medicaid Services officials for several weeks.

The KanCare waiver request, she said, is “not seen as unusual.”

Bruffett reminded the committee that CMS is expected to spend at least 45 reviewing the KanCare plan. The waiver request, she said, was filed Aug. 21.

Administration plans call for launching KanCare Jan. 1.

Asked if KanCare could be implemented without federal approval, Bruffett said a few parts would be able to proceed but most would not.

Under KanCare, virtually all of the state’s 383,000 Medicaid enrollees would be enrolled in fixed-cost managed care plans run by three for-profit insurance companies:

• Amerigroup

• UnitedHealthcare

• Sunflower State Health Plan, a subsidiary of Centene.

Brownback officials estimate KanCare will reduce the growth in state and federal Medicaid spending by $1 billion over the next five years.

Bruffett spent several minutes assuring committee members that under KanCare, services would not be cut and reimbursement rates to providers — hospitals, physicians, pharmacies, nursing homes, home health agencies, and mental health centers — would not be reduced.

“All that’s covered now will be covered” under KanCare, she said.

Providers in the current system, Bruffett said, are expected to participate in KanCare as well.

The managed care companies’ contracts with the state call for having 90 percent of their provider networks in place by Oct. 12; 100 percent by Nov. 16.

Bruffett said KDHE will conduct a “go/no-go” assessment of the networks on Oct. 19. If all three networks are deemed adequate, state officials will begin the process for “auto-assigning” enrollees to one of the networks.

If it’s given the green light, the assigning process will begin Oct. 24.

Medicaid enrollees, Bruffett said, should know their assignments sometime in early November.

The computerized assignment process, she said, is designed to minimize disruption. Enrollees should not have to change providers; a family’s members will not be assigned to different companies.

If all goes as planned, enrollees will have at least 45 days to review their plan’s benefit packages prior to the Jan. 1 launch date. If they prefer, they will be free to switch companies.

After Jan. 1, they will have another 45 days to move from one plan to another.

The system, Bruffett said, is designed to promote competition and increase efficiency.

Rep. Peggy Mast, an Emporia Republican and member of both the House appropriations and social services budget committees, said she was confident in the administration’s efforts.

Still, she added, “There’s a lot of anxiety out there.”



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