KanCare information forums begin
- on July 31, 2012
Representatives of hospitals, doctor practices and other Medicaid providers turned out in relatively large numbers today for the beginning of a series of meetings aimed at answering questions about KanCare, Gov. Sam Brownback's plan to remake the state Medicaid program.
State officials said they still hadn't resubmitted their application for the federal waivers needed to launch the administration's Medicaid makeover plan but intend to refile that paperwork "very soon" and meanwhile are moving forward with their desired Jan. 1 start date for the new program. Federal approval is necessary for the administration to advance its plan of moving virtually all of the state's 383,000 Medicaid beneficiaries into fixed-cost managed care plans run by insurance companies.
"KanCare will start in January," Gary Haulmark, commissioner for community services and programs at the Kansas Department for Aging and Disabilities Services told the crowd.
Simultaneous "education" sessions on the new program were held in Topeka and Garden City on Monday and additional sessions are scheduled this week in Wichita, Leavenworth, Salina, Hays, Fort Scott, and Overland Park.
About 350 people filled an auditorium to near capacity on the campus of Washburn University in Topeka and about 150 people attended the afternoon session in Garden City, state officials there said. Evening meetings with presentations intended for Medicaid beneficiaries also were scheduled in each of the tour cities. About 150 Medicaid beneficiaries and others attended the evening session at Washburn.
In the Topeka sessions, the KanCare plan was described by Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services and by Haulmark. They were joined by representatives of the three managed care companies newly under contract with the state. Those companies are the local subsidiaries of UnitedHealthCare, Amerigroup and Centene, each of which is a large company that has Medicaid business in multiple states.
Company representatives also spoke at the Garden City meeting, which was led by Dr. Robert Moser, secretary of the Kansas Department of Health and Environment.
The Topeka meeting for providers was scheduled for three hours, but broke up after about two had passed. Officials fielded about two dozen questions from the audience. They said they would post the full list of questions and answers on the state's KanCare information website by sometime next week.
Officials also collected questions put on notecards from beneficiaries during the evening session and pledged that all the answers, even those they couldn't get to Monday, would be posted on the KanCare webpage. Officials also talked about the additional services that will be made available to all or some Medicaid patients, including some preventive dental services for adults, which currently aren't covered by the program.
Some participants said they weren't sure what all questions they needed to be asking at this stage of the process.
"I would say the administration has been consistent in their optimism," said Amy Campbell, a representative of the Kansas Mental Health Coalition who attended both Monday sessions in Topeka. "How can they offer all these value-added services but pay them (the MCOs) less? I'm very glad they're having these meetings. But it seems like a lot of information to put together between now and December. We've never been through this before. What are we supposed to say?"
For beneficiaries, KanCare was described with a series of examples of fictional program clients with various needs and how their services or Medicaid experience might change.
In each example, the only changes were the possibility of more services and dealings with a care coordinator.
More informational meetings will be held in various locations throughout the state in September and again in October, officials said.
Here is a sampling of the questions and answers:
Q: Will any savings from KanCare be used to reduce the waiting lists for home and community based services?
A: Sullivan told the audience that state officials do not expect to cut Medicaid spending but they expect to slow the annual increase in cost of the program by about 1 percent a year for the next five years. That is expected to save the state and federal governments $1 billion over that period, he said.
"I'm not able to stand up here and say all the waiting lists will be gone in three or five years, " he said. "What we think is that this gives us more funds (available) to allocate toward them," should the governor and Legislature decide they want to reduce the waiting lists.
Q: What if a managed care company wants to pay me less than the current Medicaid fee-for-service rate?
A: Haulmark said the state's contracts with the insurance companies would prohibit them for paying less than the current rate.
"That cannot happen," he said. "The MCO (managed care organization) must pay you at least the fee-for-service rate," that is effective on Nov. 9, 2012.
Q: Will we have to switch pharmacies?
A: Kelley Melton, pharmacy program manager at the Kansas Department of Health and Environment, said the state was urging the signing of contracts between the managed care companies and the pharmacies currently doing Medicaid business with the state.
"Our goal is to have as many of the currently contracting pharmacies as possible contracted with the MCOs," she said.
Each of the KanCare MCOs is working with a pharmacy benefits subcontractor to administer its drug benefits, officials said.
Amerigroup is working with CVS/Caremark, United is working with OptumRX, formerly known as Prescription Solutions; and Centene is working with U.S. Script.
Melton said those companies would manage the pharmacy benefits but that nursing homes, hospitals, and individual Medicaid beneficiaries could continue to use their customary pharmacies, if the pharmacies join the MCO networks.
Q: Will a KanCare enrollee be allowed to change plans at any time?
A: No. Plan changes will be allowed once annually but a change in doctor or other provider will be allowed at any time, Haulmark said.
The events are open to the public but are aimed primarily at Medicaid service providers and people enrolled in Medicaid. The afternoon events are geared for providers. The evening events are directed at beneficiaries.
Tuesday in Leavenworth: From 1 p.m. to 4 p.m. at the Riverfront Community Center, Riverview Room, 123 S. Esplanade St. And from 6 p.m. to 8 p.m. at the same location.
Thursday in Overland Park: From 1 p.m. to 4 p.m. at the Tomahawk Ridge Community Center, Pinnacle and Summit Rooms, 11902 Lowell. And from 6 p.m. to 8 p.m. at the same location.