Advocates raise concerns over possible reductions in KanCare services

State officials say they expect few cuts and note appeal process

1 | Health Care Delivery, KanCare, Medicaid-CHIP

— The head of an advocacy program for the disabled said he doubts the agency would be able to help many KanCare beneficiaries who protest cuts in the services they receive.

“We’ll try, but there’s very little we can do,” said Rocky Nichols, executive director of the Disability Rights Center of Kansas. “We don’t have the money.”

Nichols said the center, which is federally funded, recently learned that its already stretched budget had been cut by 15 percent.

“A big concern of ours has been that the people who may see their (KanCare) plans of care reduced are going to be the same people who don’t have the ways or means to navigate the appeals process,” he said.

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Rocky Nichols, executive director of the Disability Rights Center of Kansas, a Topeka-based nonprofit group.

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Nichols' comments were made Wednesday during a meeting of the Mental Health Coalition of Kansas in Topeka.

KanCare is the name given to Gov. Sam Brownback’s initiative to move virtually all of the state's 380,000 Medicaid enrollees into managed care plans run by three major insurance companies: United HealthCare, Amerigroup and Sunflower State Health Plan, a subsidiary of Centene.

Medicaid beneficiaries who were assigned to one of the companies prior to Jan. 1 have until April 4 to switch to one of the other two health plans, if they choose.

In the coming weeks, Nichols said, disability advocates expect the managed care companies to begin proposing reductions in some beneficiaries’ services.

“That’s the big fear,” he said. “These are for-profit companies we’re dealing with now and there’s both a financial incentive for reducing plans of care and for keeping people healthy and out of institutional care. It could go either way.”

Kari Bruffett, director of the Division of Health Care Finance at the Kansas Department of Health and Environment, also was at the meeting. She said she did not expect the managed care companies would make “a large number” of changes in beneficiaries’ plans of care.

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

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But whatever reductions are proposed by the companies, she said, would be have to be approved by program managers at the Kansas Department for Aging and Disability Services and also would be subject to an appeals process involving both KDADS and the beneficiary’s managed care company.

Disabled KanCare plan members receiving long-term services who disagreed with proposed changes in their services would have the option of switching managed care companies, she said.

Bruffett said she hoped disability groups would be able to help beneficiaries navigate the appeal processes, saying that that it would a conflict of interest for either KDADS or KDHE to represent them.

She said those who need help navigating the system also could contact Kancare Ombudsman James Bart’s office.

“He wouldn’t be able to represent them in a hearing, but he can assist in making sure they have access to the information they’ll need,” Bruffett said. “He can help connect them to resources.”

Rosie Cooper, executive director at the Kansas Association of Centers for Independent Living, said she’s expecting the ombudsman would end up referring many people to the state's 10 independent living centers.

“We’re still here, we’re still in the business of making sure people’s civil rights are upheld” Cooper said. “We’ll do what we can.”

But that may not be much, Nichols said.

“The CILS are still there, but their budgets have been decimated in the last two years,” he said. “I don’t think any of us know how this is going to turn out.”

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)


Full Medicaid and KanCare coverage



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Comments

jdskansas (Julie Sewell)March 29, 2013 at 6:49 p.m.

No one mentions the devastation that will occur when people who are impaired are subjected to literally having their world completely changed. It is a very wrong assumption that because these people are impaired they won't know the difference. Taking away the rights of these I/DD people is fundamentally wrong.








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