Finn Bullers told legislators today that he believes a planned reduction in the in-home KanCare services he receives is an example of how the state’s new Medicaid managed care program is failing needy citizens.
But officials in the administration of Gov. Sam Brownback said cases like Bullers’ show the need for tighter management of the taxpayer-funded healthcare program that is straining state budgets.
Bullers, a 49-year-old Prairie Village man who suffers from Muscular Dystrophy, detailed his complaints about KanCare to a legislative committee charged with overseeing KanCare, the administration’s managed-care program launched Jan. 1.
The private company now managing Bullers’ care has notified him that it intends to reduce the around-the-clock care he now receives to 40 hours a week. Bullers told lawmakers that would threaten his health, “tear his family apart,” and further diminish his ability to be active in his community.
“I still have something to contribute,” Bullers said from his wheelchair, straining his barely audible voice to be heard. “I’m not dead yet.”
The 49-year-old journalist and former Kansas City Star reporter said his wife has told him that she cannot assume the burden of caring for him in addition to her full-time job, which is the family’s main source of income.
“Under the new managed care rules in Kansas, I face a 76 percent decrease in care — a move that my doctors say is wildly unrealistic and a move that my wife says will force her to file for divorce and as a result tear my family apart,” Bullers said.
Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, said he couldn’t talk about the specifics of Bullers’ case. But he said that he and several other members of his staff had personally reviewed the changes being proposed by the company.
“We are comfortable with that reduction and the decision that the managed-care company made,” Sullivan said.
Sullivan said under the state’s old Medicaid system, a single organization could certify a person’s eligibility for assistance, write the care plan, and provide services. That, he said, led to some people getting more services than they needed.
“We found that a lot of organizations were competing with each other saying, ‘come sign up with our agency and we’ll give your 20 more hours in your plan of care,’” he said.
Given that, Sullivan said, he expected wholesale changes when the managed-care companies took over in January. But he said the companies have sought to reduce services for only 8 percent of the KanCare enrollees who receive home- and community-based services.
So far, 90 percent of those reduction requests have been approved, Sullivan said.
Bullers said he intended to use every avenue open to him to fight the proposed changes in his care plan.
“When the system fails you, then you go elsewhere,” he said. “You use social media and you get out there to get the message heard. And that’s what I’m doing today.”
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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