Archive for Tuesday, December 17, 2013

Federal panel suggests delaying KanCare expansion

December 17, 2013

Topeka — A presidential advisory panel says Medicaid should delay KanCare's upcoming takeover of long-term services for the developmentally disabled in Kansas and consider having the U.S. Justice Department review whether the state has properly administered its Medicaid program in the past.

In a letter Friday, the National Council on Disability told the Center for Medicare and Medicaid Services to study the state's KanCare privatized managed-care program for poor and disabled Kansans, The Wichita Eagle reported.

The council, which is appointed by the president to advise the administration and Congress on disability policy and laws, asked CMS for a one-year pause in KanCare expansion, saying Kansas hasn't adequately considered concerns about the switch. The council wants CMS to delay granting Kansas a waiver, which the state has to obtain before Jan. 1 to move the disability services into KanCare.

"We find the start date on January 1, 2014, with public comments open until December 17, 2013, and final CMS approval yet to be determined, suggestive of insufficient consideration, response, or interaction between stakeholders impacted by the proposed waiver amendment and CMS, and state officials," the council's letter to CMS said.

Under KanCare, the state contracts with three private insurance companies to administer Medicaid services for poor and disabled Kansans.

The council also rejected an explanation from Shawn Sullivan, director of the state Department for Aging and Disability Services, that the standards for qualifying for services hadn't changed but are only being more consistently applied under KanCare.

"Such a suggestion needs further investigation by CMS and possible referral to the Department of Justice Office of Civil Rights to determine if Kansas adequately administered its Medicaid program in the past or if the MCOs (managed care organizations) are using external or variant mechanisms to place cost savings or profit over quality for people with disabilities," the council's letter said.

KanCare has been handling medical services since January 2013. The addition of home- and community-based services for the developmentally disabled would complete the transition. In two days of meetings in Topeka early this month, the council heard testimony about delayed and denied payments to medical providers and concerns that the privatized care managers are planning to reduce services for some individuals with disabilities. KDADS officials said the panels' concerns are unfounded.

"They parachuted in from the East Coast to tell us that," said Angela de Rocha, a spokeswoman for the state agency. "They're an advisory committee; they have no authority."

De Rocha said she doesn't know if the council's recommendations will have any effect on whether Kansas gets the waiver.

Shawn Sullivan, director of KDADS, said he doesn't object to a Justice Department review.

"We're transparent about the changes we've made in the system," he said.


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