Health Care

Kansas to reverse course on pediatrician pay cut, raise KanCare rates for checkups

More doctors take Medicare in Missouri than in Kansas

Missouri ranked sixth in the nation in percent of doctors taking all Medicare patients while Kansas ranked 48th in a recent survey that underlines the importance of consumers making sure their doctors are covered before choosing a plan.
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Missouri ranked sixth in the nation in percent of doctors taking all Medicare patients while Kansas ranked 48th in a recent survey that underlines the importance of consumers making sure their doctors are covered before choosing a plan.

The Kansas Medicaid director said Monday that he’s reversing a billing change that resulted in pay cuts to pediatricians and will actually be raising the doctors’ rates.

The change took a bundle of services for well-child checkups that used to be billed with a single code and separated them into 12 separate codes. Jon Hamdorf, the director of KanCare, previously said pediatricians could still get paid the same for each visit after the change went into effect Nov. 1.

But after reviewing data submitted by pediatricians Thursday night and hearing from a group of them Friday at the KanCare Advisory Council meeting, Hamdorf said he realized that wasn’t the case.

“We did identify a place where it would have been a reduction in reimbursed services,” Hamdorf said. “We’re fixing it today and our staff is going to make it retroactive to November.”

Melissa Hudelson, the executive director of the Kansas chapter of the American Academy of Pediatrics, called Hamdorf a “straight shooter” and said her members are very pleased with how he reacted to their concerns.

“I think Jon’s a great guy,” Hudelson said. “I knew that once he was able to see what the effect was, he would do the right thing. He’s definitely doing right by the providers. It’s a really good thing and it’s very appreciated.”

After the billing change went into effect, pediatricians reported that checkups for children of certain ages had fallen dramatically, like from $70 to $26 for 1-month-olds. Some said they might have to start cutting back on the number of KanCare patients they serve.

Hamdorf said that going forward, $70 will be the lowest rate for any visit, with extra added on for each of the formerly bundled services.

He said that’s still pretty low compared to surrounding states and Medicare, and he’s considering recommending that the administration of Democrat Gov. Laura Kelly, who takes office next month, raise it to about $110.

“The last thing we want to do is underpay our pediatricians,” Hamdorf said.

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Kansas City Star health reporter Andy Marso was part of a Pulitzer Prize-finalist team at The Star and previously won state and regional awards at the Topeka Capital-Journal and Kansas Health Institute News Service. He has written two books, including one about his near-fatal bout with meningitis.


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