Kansas health officials on Monday defended themselves to lawmakers over a blistering federal review of KanCare, the state’s privatized Medicaid program.
Susan Mosier, the secretary of the Kansas Department of Health and Environment, said the analysis made “statements of opinion rather than statements of fact.”
The report from the Center for Medicare and Medicaid Services (CMS) last week said that KanCare was out of compliance with federal standards. And it emphasized that a lack of oversight and communication issues may put KanCare patients at risk.
The state has to submit a corrective action plan to CMS by Feb. 17.
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The federal government also denied KanCare’s request to extend the program through 2018.
Republican and Democratic lawmakers on the Senate health committee pressed Mosier for answers during the roughly 90 minute hearing Monday.
Mosier told lawmakers that she’s hopeful the situation will be resolved “very quickly” with President Donald Trump’s administration.
“As we provide this analysis to the new administration, I do not see that we will be encountering any change in our federal financial participation,” Mosier said.
But Laura Kelly, a Topeka Democrat who serves as the ranking Democrat on the committee, responded: “I wouldn’t count those chickens yet.”
Sen. Barbara Bollier, a Mission Hills Republican, said she was concerned about the transparency between the department and lawmakers about the federal government’s review of KanCare.
“You’re telling me that these issues were there,” Bollier said. “And these are some really large issues and yet, I just met with you (recently) in my office and everything seemed to be going swimmingly. So that’s a concern to me because these are some significant issues.”
But Mosier repeatedly told lawmakers that the information detailed by the federal government missed the mark.
It was “extremely poor,” she said, and was rushed.
“I’ll admit on the surface that this letter looks alarming and concerning,” Mosier said.
Gov. Sam Brownback’s administration has criticized the federal report as being politically motivated as former President Barack Obama left office.
Kansas Democrats have dismissed that concern in the days since the report was made public.
Sen. Ty Masterson, an Andover Republican, said this could be seen as a “political skirmish between the feds and us.”
One part of the report cited concerns that KanCare stakeholders struggled to get clear and consistent information from the state and managed care organizations.
It also said that members of the public described the state as “adversarial” about the KanCare program.
“I know the meetings that I’ve been in, we did two rounds of stakeholder meetings going across the state this summer, and they were not adversarial,” Mosier said. “The ones that I’ve been in, that I can speak to, were not.”
Kelly said that wasn’t what she had seen.
“I have actually been to some of the meetings and I would say CMS is correct here,” Kelly said. “The tone of them was adversarial...you would field questions from participants in the meeting but not respond in a way that suggested that you empathized at all with the issues.”
Mosier repeatedly pointed to health outcomes as a sign that KanCare is working.
“The health outcomes have improved, looking post-KanCare compared to pre-KanCare as well as looking year over year in KanCare,” Mosier said. “This is a key metric that demonstrates that there is oversight and that it is working well.”
Some lawmakers have called for more oversight of KanCare since the federal review was made public last week.
After the hearing, Sen. Vicki Schmidt, a Topeka Republican, said lawmakers need to be kept in the loop on the state’s response to the CMS concerns.
The chairwoman of the Senate’s health committee said she was most concerned about KanCare patients’ needs and that their services are not being delayed or denied.
“I think all of us have heard from advocacy groups and certainly from individual patients and beneficiaries about issues in KanCare,” she said.