Archive for Thursday, January 19, 2017

Federal officials fault Kansas’ privatized Medicaid program; request to renew KanCare denied

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January 19, 2017, 11:01 a.m. Updated January 19, 2017, 3:07 p.m.


— Citing a host of problems and noncompliance with federal laws and regulations, the Center for Medicare and Medicaid Services has denied the state’s request to extend a waiver that allowed it to operate its privatized managed care Medicaid system known as KanCare.

In a letter dated Jan. 13, CMS said that throughout 2016 it received numerous complaints from Medicaid patients and health care providers, complaints it said were verified during an on-site review in October.

“Due to the severe and pervasive nature of the on-site review findings and the resulting impacts this has on the beneficiaries and providers, CMS is requiring Kansas to develop a Corrective Action plan (CAP) describing the actions it will take to correct the identified noncompliance,” James G. Scott, CMS’s associate regional administrator in Kansas City, said in the letter.

The official notification of CMS’s denial came in a separate letter dated Tuesday, Jan. 17.

Some of the deficiencies cited relate to the very core concepts that were supposed to make KanCare superior to traditional Medicaid programs.

The idea behind KanCare was that the state would hand over administration of the program to private insurance companies that would operate it as a “managed care” program, meaning each patient would have a plan of care, agreed to by the patient, and the companies, known as Managed Care Organizations, or MCOs, would ensure that patients were getting the care outlined in the plan.

In order to do that, however, the state needed a waiver from CMS to operate its Medicaid program differently from the traditional fee-for-service model. That waiver is set to expire Dec. 31, 2017.

Kansas applied for a one-year extension. The letters indicate that CMS is denying that request for the time being, at least until state officials submit a corrective action plan detailing how they will come into compliance.

In the Jan. 13 letter, CMS said it uncovered “significant compliance deficiencies” in the planning process, such as MCOs asking patients to sign incomplete forms, and even revising the plans without input from the patient.

CMS also said there was a lack of coordination between the Kansas Department of Health and Environment and the Kansas Department for Aging and Disability Services, the two agencies responsible for KanCare.

It also noted that, “The State’s oversight of the MCOs has diminished over the four years of KanCare operation.”

It noted that the first annual report of the KanCare program was a comprehensive document that identified issues and included corrective action plans for the MCOs. But the 2014 and 2015 reports “were each two pages long, with little content of substance.”

Lt. Gov. Jeff Colyer, who is considered the chief architect of KanCare, was in Washington Thursday to attend the inauguration of President-elect Donald Trump and to meet with congressional leaders about the future of Medicaid. He issued an email statement dismissing CMS’s action as politically motivated and said the renewal process is “on track.”

“This is simply an ugly parting shot from the Obama administration at Governor Brownback on their way out the door,” Colyer said. “It is politically motivated pure and simple, and we expect this situation to be resolved quickly once the new administration in Washington comes into office.”

Colyer said the state received a preliminary audit report in November and that it had already begun to address issues raised in that report.

“In November the state received a preliminary audit report and we had already begun to address these issues,” Colyer said. “There are no revelations in this most recent audit report.”

Kansas lawmakers, however, had a far different response to the news, which was first reported on the Topeka Capital-Journal’s website Wednesday night.

Sen. Vicki Schmidt, R-Topeka, who chairs the Senate Public Health and Welfare Committee, said she plans to hold hearings starting Monday to ask questions of KDHE Secretary Susan Mosier, whose department is primarily responsible for administering KanCare.

“Secretary Mosier was in my office for a half-hour yesterday (Wednesday) and never mentioned this,” Schmidt told reporters Thursday.

Sen. Laura Kelly, of Topeka, the ranking Democrat on the health committee who has also served on the joint KanCare oversight committee, said lawmakers have known for some time about the problems identified by CMS.

“We were telling CMS before KanCare was officially established (in 2013) that these problems were going to exist,” Kelly said. “We have been in regular communication with CMS over the last few years, keeping them abreast of what the issues were with the program.”


Calvin Anders 1 year, 4 months ago

Well, look at. A finding that putting businesses with a profit motive into service provider roles and failing to supervise them results in poor care. Who could have ever guessed that would happen? Privatization isn't automatically awful. But when law makers and bureaucrats act with political and economic motives, with little or no thought to the fate of those who depend on services, they need to be held accountable. This is a case where those in charge of policy on these services prioritize money and political ideology and satisfying the bare minimum of regulatory requirements over any concern for those they serve. It's pretty horrible to think about what monsters these people are.

Theodore Calvin 1 year, 4 months ago

Doesn't matter. De Rocha, Brownback, et al, don't care. It will either be liberal media bias, or political motivation, or whichever lame excuse they will use to plow full steam ahead and ignore any real facts. It's coming at a national level too. Good job, thanks a lot to all the one-issue voters who put these clowns in charge.

Phillip Chappuie 1 year, 4 months ago

The legislature doesn't need to ask Mosier or Coyler anything. All they will get is DeRocha styled canned answers. Maybe talk to some more providers that got gyped out of payment because the renewal systems failed badly. Talk to some disabled people who have had services arbitrarily cut and no longer meet the needs. The MCO's are all about cutting the care and then cut 'n paste the plans written by somebody else. It is a total disaster. I know one case a doctor order 24 hour supervision and the MCO said no, so when the provider ensures safety they do so at a loss. I heard one company had to shut down in JOCO because of service cuts. Terrible.

Bob Summers 1 year, 4 months ago

Yes. The government Liberals will take care of you. Just look at single payer VA hospitals are taking care of Veterans.

All the government Liberals have to do is confiscate enough money. It will work because the government will tell you it does.

Bob Reinsch 1 year, 4 months ago

Maybe if we could get the GOP to stop cutting benefits for the VA they could do a little more to help. When you take on responsibilities, you have to live up to them. Stop thinking like a deadbeat dad.

Cliff Sperry 1 year, 4 months ago

Bob Summers, what do you know about KanCare? I think nada. All of your posts are only anti-"liberals", few have any real content to them. It's always best to discuss/comment on issues and topics that you know something about. Oh, I forgot that your "issue/topic" is always anti "liberal". Excuse me ....

Corey Williams 1 year, 4 months ago

Actually, my dad is being well taken care of by the VA. And my father in law is being taken care of also. So maybe if you had a little personal experience in the matter, you might be able to do more than regurgitate talking points.

Michael Kort 1 year, 4 months ago

So, does KanCare go on existing until Dec. 31st, 2017, giving the state more time to unscrew things up ? or does it just fold up its' tent today and vanish,.... or do that on Dec 31, 2017 ?

Just put government into the bath tub and drown it in debt has been their motto all along and now they have no employees to take back Medicade responsibility with because they went to private vendors an got rid of their state workers who did that job .

Gary Pomeroy 1 year, 4 months ago

"Secretary Mosier was in my office for a half-hour yesterday (Wednesday) and never mentioned this," Schmidt told reporters Thursday. Is anyone really surprised?

Shaun Battles 1 year, 4 months ago

Brownback should resign,. This is what happens when you have an unqualified leader.

MerriAnnie Smith 1 year, 4 months ago

Wait til Trump hears about it. He'll fix it for Kansas. He'll ablolish the department that did the audit. YOU'RE FIRED!

Joe Blackford II 1 year, 4 months ago

My wife & I were discussing Secretary Mosier @ lunch today, as she was our ophthalmologist, 2000- her debut as a full-time bureaucrat. "Not back to her practice," was my wife's guess regarding what Mosier's plans were upon the end of the Brownback years. Dr. Mosier always seemed to be a caring healthcare provider. Not so much since she took over KDHE & KanCare.

Richard Heckler 1 year, 4 months ago

Customer satisfaction seemed to be the deciding factor or can we say customer DIS-SATISFACTION is the deciding factor.

"In the Jan. 13 letter, CMS said it uncovered “significant compliance deficiencies” in the planning process, such as MCOs asking patients to sign incomplete forms, and even revising the plans without input from the patient."

The president of the United States most likely was not involved instead the CMS is doing its' job. As taxpayers would expect for their money.

Is the Lt Governor and the Governor somehow personally invested in Kan Care as profiteers?

John Brazelton 1 year, 4 months ago

The only service that federal government can operate successfully is the Department of Defense and even then they spend way too much money. They fail badly in all over areas: education, prisons, transportation, energy production, agriculture and any other area you can think of. The worst concept in American government is send all your tax money to Washington, DC,; have federal bureaucrats take their cut and then send 50% back to the states for their use. Keep a majority of tax money at the state level in the first place and cut out the federal bureaucrats!

Greg Cooper 1 year, 4 months ago

You do know, I hope, that Kansas is a net tax receiver, right?

MerriAnnie Smith 1 year, 4 months ago

Then why are interstate highways so much better than Kansas roads?

Michael Kort 1 year, 4 months ago

Put it in the bath tub and drown it in debt, private share holder greed and deliberate top down from the state to the privately managerial incompetence........and of course,...... terminate the previous state employees responsible for running the daily shop at Ks Medicaid, who are nolonger there to give it all back to !

How slick is that ? ,

Get ride of the rural hospitals, get rid of the state mental health hospitals and send those there to the local ER at LMH and elsewhere, destroy federal funding for Ks Medicaid so that you can eventually disown it all together ! ! !.

Throw out as many republicans as you can in the next election cycle ! Q Screwing the poor and the middle class is always in their handy work............. and they should be ashamed of themselves .

Ship all of the sick and the mentally ill up to the Capitol Building where Sam can lay his healing hands onto them .

Just tell them not take an jewelry or a wallet for Saavior Sam will most certainly lay hands on them and certainly unload their valued burdens if he can . .

Richard Heckler 1 year, 4 months ago

Petition – Stop Wall Street Pension Scams/Theft

KPERS Is in serious trouble if not in jeopardy..... no matter what.

Americans have not witnessed economic inequality favoring the richest 1% since the 1920s and it is about to get worse; much, much worse if the Koch brothers’ American Legislative Exchange Council (ALEC), State Policy Network, and their Republican facilitator Paul Ryan have their way.

There has been virtually no increase in wealth for everyone below the top 0.1% of Americans.

Republicans, Koch brothers, Wall Street, ALEC, and the State Policy Network are crusading to rob to enrich corporations, Wall Street, and the richest 1%.

Toward the end of 2013, ALEC joined its Koch-funded sister organization, the State Policy Network, in a campaign to dismantle public pension systems completely as one of its top 2014 legislative priorities.

The Plot Against Pensions that focused on the work of a former Enron executive, John Arnold, to promote the false notion that there is a public-pension “crisis” that is solved by replacing pension programs with scams that shift all the risks to workers, eliminates benefits, and create incredible new profits for Wall Street.

ALEC decided pension wealth for retirees was better spent on tax cuts for the rich and Wall Street and is working to convince states to convert public pensions to 401(k) plans or other “defined contribution” plans that took a righteous beating in the 2008 market crash.

Petition – Stop Wall Street Pension Scams/Theft

Richard Heckler 1 year, 4 months ago

Regarding the KAN CARE issue ....... has some level of fraud been committed?

Where did the Medicaid dollars go?

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