KanCare oversight panel to hear concerns and complaints
Topeka ? Officials from Lawrence Memorial Hospital will be among more than a dozen organizations and individuals scheduled to testify before a legislative committee Tuesday about problems they are encountering with the state’s privatized Medicaid system, known as KanCare.
“They’ll make a presentation on various issues that we have with KanCare, including some examples of things that make process cumbersome like timeliness of responses, the appeals process, case management and peer reviews,” LMH spokeswoman Janice Early said.
The meeting of the KanCare Oversight Committee comes at a time of growing concerns over how all of the state’s health care programs are being managed, from getting eligible people enrolled in Medicaid, to reimbursements for providers, and even management of the Osawatomie State Hospital, which recently lost access to federal funding after auditors found a “systemic failure” to supervise care, perform required safety checks and protect suicidal patients.
All of those issues are expected to be discussed Tuesday.
“I have had multiple concerns from the very beginning when we started (KanCare) on January 1, 2013,” said Rep. Barbara Ballard, D-Lawrence, who serves on the joint committee.
Beginning in 2013, Kansas began putting all of its elderly and disabled Medicaid patients into managed care plans administered by private insurance companies. Children and families had been in privatized managed care plans for years before that.
The idea was that the elderly and disabled, many of whom suffer from multiple chronic health conditions, would be better served in a managed care program where “care coordinators” could make sure the patients received all of the care they need, including preventive care and ongoing treatment and therapy, reducing the need for costly emergency treatment and hospital re-admissions.
But some critics of the new privatized system say it hasn’t produced the results that were expected and instead has caused bureaucratic problems that result in delayed payments to providers and, in some cases, delayed treatment for patients.
“Clearly there are some very serious concerns,” said Sen. Laura Kelly, D-Topeka, who also serves on the oversight panel. She cited issues involving “prior authorization,” in which health care providers are supposed to get approval before providing certain kinds of care, which she said often results either in providers not getting paid, or patients not getting care.
“Traumatic brain injuries, for example, are like strokes,” she said. “You’ve got to get in there quick. If you wait, that’s when damage sets in. Some of these folks are gong to TBI facility and getting services, then they’re told ‘no, that wasn’t authorized.'”
Although management of the state’s mental hospitals falls outside the scope of the oversight panel, officials said Monday that the problems at Osawatomie State Hospital will be discussed. The hospital is administered by the Kansas Department for Aging and Disability Services, which also administers some parts of the KanCare program.
Republican leaders of the committee did not return phone calls Monday seeking comment.
The meeting, which was originally scheduled to begin Monday, was postponed until Tuesday because of weather conditions in Topeka and other parts of the state. The meeting is scheduled to begin at 9:30 a.m. Tuesday at the Statehouse.