State officials propose trimming number of KanCare workgroups

Plan presented to KanCare Advisory Council

0 | KanCare, Medicaid-CHIP

— State officials say they want to consolidate four KanCare workgroups into two and include more Medicaid enrollees or their family members on the remaining panels.

"Now that we're implementing (KanCare), we need to look at things a little differently and have more consumer input," Becky Ross, Medicaid initiatives coordinator at the Kansas Department of Health and Environment, told members of the KanCare Advisory Council during a meeting today at KDHE headquarters in Topeka.

The current workgroups, some of which have as many as 25 members, are organized to deal with issues related to these topics or areas of concern:

  • Service Providers,
  • Managed Care Organizations,
  • Member Involvement and Protections, and
  • Specialized Healthcare and Network Issues.

Generally, the groups have been meeting at least once monthly since July in anticipation of KanCare, which is the name given Gov. Sam Brownback's initiative to move virtually all of the state's 380,000 Medicaid beneficiaries into privately run managed care plans.

KanCare was launched Jan. 1 and is expected to be in a transitional phase for at least the next 90 days.

Federal requirement

The state needed federal approval in the form of a so-called Section 1115 Medicaid waiver in order to begin KanCare, which is described by the Centers for Medicare and Medicaid Services as a five-year demonstration project.

One of the conditions of the approval was that the state must have at least one KanCare "advisory committee" for the duration of the five years of the project.

The panel must include "individuals, interested parties and stakeholders impacted by the demonstration's use of managed care," according to the special terms and conditions spelled out by CMS in a document made public Dec. 28, less than a week before KanCare began.

Ross said many members of the workgroups had stopped attending the meetings, so they would be the first dropped in the consolidation.

Kari Bruffett, director of the Health Care Finance Division at the Kansas Department of Health and Environment, said the administration would try to keep on the remaining panels the people from the workgroups who had been steady participants, but that no one would be tapped for the new groups unless they submitted a nomination form or someone submitted a form recommending them.

photo

Kari Bruffett, director of the Health Care Finance Division at the Kansas Department of Health and Environment.

View larger photo

She also said special effort would be made to include more Medicaid enrollees and that the Medicaid providers' workgroup would be retained.

The KanCare Advisory Council, which was formed in March last year, has 19 members. The workgroups report their activities to the council. The workgroups and the council have been sounding boards for various concerns as KanCare has advanced from concept to reality.

The council took no action on the administration's consolidation proposal, but received proposed working charters for the new panels to consider at a later meeting. The council is next scheduled to meet March 12 in Topeka.

Primary care provider questions

In other developments:

Representatives of each of the three managed care companies reported that their customer call centers were receiving more than 1,000 phone calls a day since KanCare was launched. The companies are United Healthcare, Amerigroup and Sunflower State Health Plan, a local subsidiary of Centene.

The top reason for the calls, they said, were questions from beneficiaries about the primary care providers listed on their medical cards or requests to change the listed primary care provider.

Spokespersons for each of the companies said their plans would pay for services from any primary care provider but the fact that many Medicaid enrollees were finding unfamiliar or non-preferred providers listed on their cards was creating confusion and questions for them about how they should or could access medical services.

David Sanford, a member of the advisory council, and chief executive of Grace Med, a Wichita safety-net clinic, said some of the managed care companies had failed to list safety-net clinics on the cards, which was creating confusion and billing concerns for clinics across the state and their clients.

"Cash flow is particularly important," Sanford said. "Some of the clinics could be in some financial difficulty, if this is not addressed quickly."

The managed care companies and state officials have acknowledged some problems associated with KanCare's launch but have described them as manageable and within the range of expectation for a major system change.

Issues log and rapid response calls

State officials have been holding daily 9 a.m. "rapid response" telephone conferences that are scheduled to continue at least through the remainder of the month. The teleconferences are intended to provide quick answers to questions about KanCare and provide a venue for people in the Medicaid system to alert officials to problems. To join the teleconference, dial 877-247-8650 and enter ID code 79687456.

State officials also have begun posting an "issues log" on the KanCare website, detailing some questions and problems noted by Medicaid providers and enrollees and the status of the "issues." As of Wednesday, the log included 29 issues. Four were marked "pending" resolution and the remainder were marked "resolved."

KHI News Service coverage of KanCare

Hutchinson Clinic's letter throws a curve to KanCare open enrollment (1/28/14)
National Disability Council again urges CMS to hold off on Kansas DD carve-in (1/14/14)
DD carve-in not approved for Jan. 1 launch (12/27/13)
National Council on Disability urges one-year delay of KanCare DD carve-in (12/13/13)
KDADS chief describes lessons learned with KanCare (12/5/13)
Other states watching Kansas as it implements ‘unprecedented’ Medicaid model (12/5/13)
KanCare reimbursement problems continue for providers (11/25/13)
Kansas dental program for children on hold because of KanCare MCO (11/11/13)
Kansas Medicaid providers complain to oversight committee (10/7/13)
Wichita hospital execs describe problems with KanCare (8/29/13)
KanCare to adopt “health home” model for treating mentally ill (7/22/13)
Kentucky’s rush into Medicaid managed care: A cautionary tale for other states (7/18/13)
DD groups largely reconciled to KanCare carve-in (7/15/13)
Advocates urge more government oversight of Medicaid managed care (7/8/13)
Independent pharmacists push for KanCare contract enforcement (7/1/13)
Payroll agents for the disabled on Medicaid say they are struggling under KanCare (6/3/13)
Personal Care Attendants: KanCare's unheralded workers (5/20/13)
House GOP leaders pen letter backing DD supports in KanCare (5/17/13)
More than 1,000 rally at Statehouse for DD carve-out (5/8/13)
Nothing to be done about coverage gap in states not expanding Medicaid, feds say (4/29/13)
As KanCare continuity of care period ends, problems persist; legislators starting to hear about it (4/8/13)
Advocates raise concerns over possible reductions in KanCare services (3/28/13)
Conferees agree on KanCare oversight committee (3/28/13)
DD advocates push to extend KanCare "carve-out" (3/20/13)
Safety-net clinics struggling with KanCare (3/4/13)
Major medical provider groups ask for longer KanCare transition (2/13/13)
Lawmakers and providers assess KanCare transition (1/28/13)
Five-part series: "Lower cost and better care: Can KanCare deliver?" (1/14/13)
Independence of KanCare ombudsman questioned (1/7/13)
KanCare special terms and conditions spelled out by CMS in a document (12/28/12)
KanCare workforce shift hampering local agencies (12/10/12)
Governor announces KanCare approval by feds (12/7/12)
More KanCare implementation details outlined (12/3/12)
Federal officials say they hope to act soon on KanCare waiver request (11/28/12)
New KanCare info included on state website (11/20/12)
Groups call for KanCare delay (11/8/12)
Go/no-go date looms this week for KanCare (10/15/12)
KanCare benefit packages outlined (9/26/12)
Provider groups nervous about lack of KanCare details (9/13/12)
KanCare Confidential (9/10/12)
KanCare contracts awarded (6/27/12)
KanCare plan panned again at public hearing (6/20/12)
Wichita KanCare forum draws more than 200 (6/19/12)
Medicaid makeover: Can Kansas learn from Kentucky? (6/11/12)
Hundreds protest inclusion of disability services in KanCare (4/25/12)
Counties weighing in on KanCare (4/9/12)
Hospital administrator to chair KanCare Advisory Council (3/29/12)
Brownback Medicaid makeover an “ambitious” plan (3/28/12)
KanCare bidders heavily courting Medicaid providers (3/19/12)
Legislators push to delay KanCare start (3/7/12)
Brownback announces managed care for all in Medicaid (11/8/11)
Kansas Medicaid makeover in the works (3/7/11)


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