It appears a proposal to create a new legislative committee to oversee the implementation of KanCare could have smoother sailing this year than last.
A hearing on House Bill 2025 was held today in the House Health and Human Services Committee and lawmakers heard it endorsed by officials from the Kansas Department of Health and Environment and the Kansas Department for Aging and Disability Services, the state's two main Medicaid agencies.
Representatives of a variety of consumer groups also spoke in favor of the measure and many more presented written testimony. At least 16 organizations are behind the bill, including the Lieutenant Governor's Office.
Hearings originally were scheduled on the bill for today and Thursday, but the second day of testimony was cancelled this morning. Rep. David Crum, an Augusta Republican who chairs the Health and Human Services Committee, said the proposal had no opponents, or at least no one had signed up to testify against it.
The measure would establish a joint committee of 11 senators and representatives with the chairmanship rotating between members of the House and Senate. The first chairperson would be a House member.
A move last year to create an oversight committee also had broad support but broke down after the House and Senate failed to agree on who should be on it and which chamber should provide its first chairperson. Those frictions don't seem to exist this year.
House Speaker Pro Tem Peggy Mast, an Emporia Republican, told KHI News Service that she expected the bill or some version of it would be passed before the Legislature adjourns.
"I don't think it's really going to have any blockades this year..I think there's just a different feel between the two chambers and I think they'll come up with a solution where we can have proper oversight of KanCare," she said.
KanCare is Gov. Sam Brownback's initiative to move virtually all the state's 380,000 Medicaid beneficiaries into health plans run by three commercial insurance companies. The new program began Jan. 1.
Prior to KanCare about two-thirds of the state's Medicaid beneficiaries, chiefly pregnant women and children, were enrolled in managed care plans. KanCare changed the contractors and also rolled into managed care the frail elderly, physically disabled and the mentally ill.
The Brownback administration also is planning on Jan. 1, 2014, to include in KanCare the long-term services for the developmentally disabled, currently about the only major area of Medicaid services not within the program. Advocates for the developmentally disabled have said they will continue to fight that though and a bill has been introduced that would maintain that "carve-out," though it has not been scheduled for a hearing.
Frequent reports from the MCOs
KDHE Secretary Dr. Robert Moser told committee members his agency supports creation of a review committee and described some of the oversight of the KanCare contractors already being done by his agency. He said the managed care companies gave KDHE daily reports in January detailing problems encountered as the program was implemented and the timeframes in which the problems were resolved. He said those reports continue, but now are submitted twice a week.
He said the ageney also gets weekly updates from the companies on the status of their respective provider networks.
Daily "rapid response" teleconferences held since December so Medicaid providers and others could call in to state and insurance company officials with questions or comments about KanCare will continue through the end of this week and then be held twice a week starting next week, he said.
The proposed legislative oversight committee also would be specifically charged with overseeing the state's home and community-based social service programs, which are Medicaid funded.
Mitzi McFatrich of Kansas Advocates for Better Care, a nursing home watchdog group, urged creation of the committee, saying it would be especially important in the first year of KanCare when much of KDHE's oversight focus would be on business processes such as assuring that Medicaid providers are paid in timely manner.
"Measures that track business activity do not measure the health outcomes of elders and vulnerable adults," she said. "Only one metric, reducing (nursing home) resident falls, relates directly to health of adults in adult care homes. It is our hope that legislative oversight will encourage the tangible health outcomes for residents and the metrics to measure, such as tracking actual nurse staffing levels in nursing homes from payroll data and regular maintenance dental coverage for frail adults."
The state's contracts with the KanCare insurance companies include provisions for incentive payments to them if they improve health outcomes for program enrollees, but those begin in the second and third years of the five-year contracts.
No action was taken on the bill today. Crum said the committee probably would vote on it and other bills it has under consideration later this week. Friday is the last day for most House and Senate committees to pass out bills originating in their respective chambers.
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