KHI News Service

Ombudsman says most KanCare concerns are being resolved

By Dave Ranney | January 16, 2013

Kancare Ombudsman James Bart today assured members of the Senate Public Health and Welfare Committee that he’s been able to resolve most of the 74 complaints that have reached his office since it opened on Jan. 2.

“It’s been pretty hectic,” he said, “but I’ve been able to clear my emails and my voice mails every day.”

Bart said he’s heard from 46 consumers and 28 providers.

Almost 95 percent of the concerns raised by providers and 89 percent of those raised by consumers were resolved within a few hours or days. The remaining issues, he said, were in the process of being addressed.

“On the consumer side of things, there are still a lot of folks who don’t realize that the state is still in charge of determining (Medicaid) eligibility,” Bart said, noting that he’s helped expedite information exchanges between the Department of Children and Families and the KanCare managed care companies.

“The number one concern among providers,” he said, “is ‘whether I’m going to get paid on time.’”

But the insurance companies, Bart said, appear to be processing the providers’ billings in a timely manner.

Bart said he’s also been hearing from consumers who have learned that their primary care physicians are not in their managed care company’s networks. Many consumers, he said, assume that that means they should switch to whichever company’s network includes their physician.

“There is apprehension among consumers that because ‘Provider X’ is not in their network today, that they are not going to be in network in the future,” he said.

But that may not be the case, he said, because providers still may be in the process of signing on with the other managed care companies. Providers can be in the networks of all three KanCare companies.

Bart said he’s been reminding consumers that for the first 90 days of KanCare, which began Jan. 1, they’re free to continue seeing doctors who are outside their managed care company’s network. In the meantime, he said, “as the dust settles,” their providers may sign with the network they’ve been assigned.

“Just because a provider is not in the network today doesn’t mean they have to switch to another carrier unless they feel that’s necessary,” he said.

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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