Managed care organizations’ ‘lack of will’ seen as snag in KANCARE payments

Rep. Peggy Mast, District 76
Kansas House Speaker Pro Tem

020914_rep_mast_peggy_1Last week we were briefed on KANCARE, which is the program that handles all the Medicaid programs in the state. The payment system for KANCARE is set up through three Managed Care Organizations who offer different options for individuals who are eligible for Medicaid. The cost of Medicaid has been expanding recently. It is up to nearly 20 percent of the state’s budget with 411,000 people being served and a big increase in applications since the Affordable Care Act was passed in Congress. There are currently 30,000 providers of care for the different KANCARE population in Kansas. Some people feel the state has given up oversight of the contracts but that is not the case. The KDADS Agency is keeping a close eye on the contracts.

One of the biggest problems so far seems to be the reimbursement to providers. Many providers believe the problem stems from a lack of will of the managed care organization to make prompt payment. As a result of concerns we are in the process of completing a bill that would force prompt payment from the contractors. If the payment is delayed, it would be tied to a fine that will go to the provider of services.

Another issue, which has been problematic for some time, is the use of the emergency rooms instead of medical homes. For Medicaid recipients, there is no co-pay. The discussion has started to require a co-pay for emergency room visits which will likely reduce the number of times people choose the emergency room just as a convenience. When services are free, they are usually over utilized. Via Christi, the largest provider of health care services throughout Wichita and central Kansas has seen a 3 percent reduction in emergency room visits since KANCARE. This is a sign the care coordinators are beginning to have an effect on guiding patients to medical homes.

Legislative pages

I was honored to host 13 legislative pages. The students had the opportunity to observe the business of the House, followed by lunch. Of course, the day would not be complete without a tour of the freshly renovated Capitol and dome. Pages were: Kenji Anderson, Kaila Chea, Rachelle Cathcart, Colton Wellnitz, Juliana Saxton, Bethany Cathcart, Daniel Huber, Isaac Huber, Megan Gordon, Grayce McAllister, Skyler Beatty, Mark McAllister, Caleb Hollenbeck.

Visitors from home

I was happy to meet with constituents from Osage­­ City who work with the Credit Union Association. It was also a very pleasant experience to have individuals from the ESU Kansas Small Business Development Center stop by to discuss the great programs they offer and show the results of their work in helping businesses across my district.

This week also gave me the chance to see individuals who wanted to visit about aging and disability issues. I found this to be a productive discussion and I look forward to speaking with this group again.

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