Opinion

Steve Rose: Reforms needed to save KanCare

A scathing report that found Kansas’ privatized Medicaid program severely lacking raises important questions about how to ensure that services are provided and paid for in a timely fashion. State Sen. Barbara Bollier helped author a bill that could help.
A scathing report that found Kansas’ privatized Medicaid program severely lacking raises important questions about how to ensure that services are provided and paid for in a timely fashion. State Sen. Barbara Bollier helped author a bill that could help. jsleezer@kcstar.com

Kansas state Sen. Barbara Bollier, a retired physician, told me KanCare is a disaster.

At the same time, Kansas Lt. Gov. Jeff Colyer, a physician who devised the privatized Medicaid program that provides health care to low-income and disabled Kansans, said, “The success of KanCare has been outstanding, and it should serve as a model program for states looking to modernize Medicaid.”

So, who’s right? Apparently, Bollier.

KanCare got a major spanking in a federal investigation by the Centers for Medicare and Medicaid Services (CMS). The scathing report found the program “substantively out of compliance with U.S. law and regulations.” The investigation found KanCare poses a risk to the health and safety of some participants.

Colyer predicted the new administration under President Donald Trump would overturn the findings because, the lieutenant governor alleges, the report was politically motivated — an attack on Kansas Gov. Sam Brownback.

Bollier, a Mission Hills Republican who serves as vice chair of the Public Health and Welfare Committee, believes there is a chance the report may be tossed out by the new administration. But Bollier protests the notion that the report was “politically motivated.”

“Why would Kansas be singled out?” Bollier pondered. “And why would this report be political?” CMS is a part of the Department of Health and Human Services.

Kansas was given until Feb. 17 to come up with a corrective action plan, assuming the report is not overturned.

Already, there is bipartisan support in the Legislature for a KanCare inspector general, a post that has been vacant for three years. And a bill just introduced would put that inspector general in the office of the Kansas attorney general instead of under the Kansas Department of Health and Environment. The additional independence and prosecutorial authority would put more teeth into the inspector general’s role.

Bollier was well aware of problems with KanCare before the report was issued. She had been hearing firsthand from providers such as Children’s Mercy Hospital South in Overland Park, where officials say they are struggling to sustain their participation because of low reimbursements from KanCare. She has heard from constituents who say their services have been cut.

Bollier said providers constantly complain of reimbursements delayed for months, even a year or more in some cases.

The $3.4 billion program, managed by three insurance companies, was supposed to save the state a substantial amount of money, which it has. The insurance companies keep the costs of services down in order to make a profit, which Bollier says they are doing.

Bollier sees no problem with that objective, as long as services are being appropriately provided and paid for in a timely fashion, but she said there has been little oversight. Although there is a KanCare oversight committee in the Legislature, Bollier claims its members “do not do anything.”

Bollier is doing something. Before the CMS report was released, she helped author a bill that presciently addressed many of KanCare’s shortcomings. If her legislation is passed, which it should be overwhelmingly, Kansas will have gone a long way toward fixing KanCare. The program itself is worth saving, if — and this is a big if — the reforms in the bill are implemented.

One promising action has already been taken: Bollier was just appointed to serve on the KanCare oversight committee. She will make certain the oversight role is taken seriously.

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