Lawmakers mull KanCare changes in light of critical federal report

Kansas lawmakers were already gearing up for major changes to the state’s privatized Medicaid program, but the urgency for change has increased dramatically following a federal audit that determined the state was out of compliance with federal regulations.

Sen. Barbara Bollier, a Mission Hills Republican, introduced a bill last week that she said would reform KanCare, the state’s $3.4 billion privatized Medicaid program.

Bollier and other lawmakers had begun work on the bill before the Center for Medicare and Medicaid Services (CMS) rejected the state’s request to extend KanCare’s authorization waiver through 2018.

“This is a place to start off things that need to be reformed,” Bollier said. “Obviously, if they won’t even approve our waiver, there are some serious issues to be dealt with, so we need to get that taken care of.”

The changes would include streamlining patient data from the managed care organizations within KanCare, while also putting a cap on the organizations’ administrative spending and suggesting other efficiencies for providers and patients.

Other reforms may have to be added to her legislation based on the federal government’s recent report, Bollier said.

The issues identified by federal investigators included concerns that:

▪ Kansas has not created clear roles and responsibilities for the state workers who operate the program.

▪ There’s limited coordination between the Kansas Department of Health and Environment and the Kansas Department for Aging and Disability Services. Communication issues within the state could lead to health and safety risks.

▪ The state does not have a comprehensive system for reporting and tracking critical incidents. CMS found this lack of oversight increases chances that KanCare recipients’ health, rights and safety could be at risk.

▪ Kansas does not have sufficient oversight of the managed care organizations

▪ Stakeholders in the KanCare program struggled to get clear and consistent information from the state and managed care organizations,

Gov. Sam Brownback’s administration has blasted the decision to deny Kansas’ extension as being politically motivated.

Kansas must seek public input on corrective actions and submit a plan to CMS by Feb. 17.

KanCare launched in 2013, shifting the responsibility of providing health coverage to low-income families and disabled Kansans away from the state to three private insurance companies. The program, which relies on a combination of state and federal funding, serves more than 400,000 people in the state, according to the Medicaid program’s website.

House Minority Leader Jim Ward, a Wichita Democrat, told reporters Friday that lawmakers should start by taking one group out of the KanCare mix.

“My first suggestion will be a bill that will take the disability community out of KanCare and put them back on traditional Medicaid,” Ward said. “They should have never been put into this risky scheme that hadn’t been tried and had not been tried anywhere else in the country, for the disability community.”

Rep. Dan Hawkins, a Wichita Republican who chairs the KanCare Oversight Committee, said he wouldn’t support a proposal like Ward’s that would take the intellectual and developmentally disabled out of the program.

“We believe that KanCare is certainly a program that is worth continuing,” Hawkins said. “We’ve got our problems. Nobody’s saying that we don’t have some problems. But carving that out just puts it back where it was, and I’m not sure that that’s necessarily the right answer either.”

Both Ward and Hawkins agree that the state needs to fill an inspector general position that could help oversee the state’s program. That post within the Kansas Department of Health and Environment has been empty since 2014.

Hawkins has a bill that would shift that position from the Kansas Department of Health and Environment to the attorney general’s office.

Hawkins said that he thinks if the state had an inspector general during the past three years some of these issues would have been dealt with sooner.

This story was originally published January 20, 2017 at 7:50 PM with the headline "Lawmakers mull KanCare changes in light of critical federal report."