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KS: KanCare Medicaid plan far from final

By   /   September 12, 2012  /   News  /   3 Comments

By Gene Meyer | Kansas Reporter

Medicaid reform details await federal nod as Jan. 1 deadline approaches.

TOPEKA – Kansas Medicaid experts are still working out details of the state’s new  health planwhich is supposed to be up and running by January, the state’s lieutenant governor said Wednesday.

Kansas wants to start the radically overhauled Medicaid plan Jan. 1, giving day-to-day administration of the $3 billion program to three health-care management insurance companies hired in June to run KanCare.

Kansas now runs a traditional Medicaid plan in which the state and the federal government jointly pay doctors, hospitals and other health-care providers directly for services to low-income and disabled patients.

Changing to a managed care plan, in which insurance specialists would potentially cap what gets paid, requires permission from the federal Centers for Medicare and Medicaid Services. CMS has not indicated when it might announce a decision or what potential regulatory strings might be attached to any approval.

“Guidance from CMS has not been finalized,” Kansas Lt. Gov. Jeff Colyer, said in national press teleconference called by a Florida think tank to promote similar Medicaid reforms throughout the U.S. Colyer is a surgeon named by Kansas Gov. Sam Brownback to head the Medicaid reform project.

But until a decision is made, neither Kansas nor any other state considering a similar change can resolve all of the details needed for the program to work. So, Colyer said Wednesday, “we have not made any official statements yet.”

All but three states in the U.S. – Alaska, New Hampshire and Wyoming — hire managed-care specialists to run at least part of their Medicaid programs. But few are trying to switch so massively as Kansas or Florida, which is seeking federal permission to expand to statewide a five-county pilot program established in 2006 by then-Gov. Jeb Bush.

Bush, a Republican, also took part in the teleconference sponsored by the Foundation for Government Accountability, a Naples, Fla., think tank that advocates Medicaid reform and free-market solutions.

Traditional Medicaid programs have become a “pay and chase system in which all the incentives are aligned to create a system that didn’t create a health care system we wanted,” Bush said.

But Greg Mellowe, policy director for the Florida Community Health Action and Information Network, or CHAIN, in Jupiter, Fla., counters that Medicaid reform requires more than simply turning the programs over to private managers. CHAIN is an affiliate of Families USA, a national health care consumers advocacy group in Washington, D.C., and both organizations have been critical of Medicaid managed-care efforts.

“There are reasons why, seven years later, legislation to take managed care statewide remains unfinished,” Mellowe said in a telephone conversation after the news conference.

“We’re still struggling with issues of accountability, and assurance about quality of care,”  he said.

Total Medicaid spending hit $401 billion nationally in 2010, and it’s projected to jump to $586 billion in 2014, when expanded federal Affordable Care Act eligibility rules kick in, according to CMS Medicaid regulators. Totals could top $908 billion by 2020, the farthest year that CMS projected, if nothing changes.

States simply can’t afford to pay their share of those escalating costs, Bush said.

“If you don’t have Medicaid reform, you don’t have money for education or other needs, either,” he said.

Contact Gene Meyer at [email protected]

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Gene formerly served as staff reporter for Watchdog.org.

  • Medicare is spending 13 times the amount to have infusions provided in a hospital setting because they can’t figure out how to fix their system to pay infusion clinics enough to conduct their mission at 1 13th of the cost. Most of these clinics have closed, having lost their investment and won’t return. I can’t see it as anything but gross incompetence. I can only assume the whole system is replete with this failed performance. That should be the focus of your reform.

  • I am
    disabled on SSDI. I will be forced to choose to downgrade my current great
    healthcare.
    I have been studying this new plan since it will be life and
    death decisions as my case is most complicated. So far, I will
    not be able to keep my doctors of ten years, since I became disabled. That initself is a potential death sentence for me. Under the system in place
    now, I have recieved excellent treatment and management through the Cotton O’niel/Stormont Vail system. In fact I have shown some remarkable improvement in the last month, under the Medicaid in place now.

    After studying the 3 plans offered , calling them and the internet, I can only
    conclude the new KanCare is a political milestone in republican reactionary ass hattery. It all boils down to third world medicine.. Your choices of Primary’s are filled with PA’s, and un-certified, and mostly foreign doctors. I can’t help
    but feel these medical personnel can’t get a job elsewhere, or be certifiable.
    Is that the doctor you want? Not me. It would be my worst nightmare to have to hand over my most complicated health care to a PA, or someone really hard to understand, or that can’t understand what I’m telling him.

    It certainly is a deadly attack on the elderly, disabled and the poor. I can only imagine how other disabled and dependant folks are reacting to this. I can’t help but have the feeling of getting on a boxcar full of people to take a shower.
    And yes, I have already reacted. While talking to all 3 of the insurance offered, None of the receptionist I talked had ever heard of Cotton ONiel, and not many Stormont Vail. After arguing the fact that the Federal disability right acts act says I can have the Doctor of my choice, I could not convince them that I had no need or want the proposed health care system They couldn’t really argue that point. I don’t think there is a solid argument that can be made against that Federal Law’s right to choose any Doctor. They said yes, I have the right to choose anyone of our doctors that we contract with. I said you haven’t contracted my doctors, the ones I chosse, not you. The Federal law does not include any states right to choose one for me. They finally gave up and said a State Official will be calling me. I said yes, please do.

    So the guy calls me. Here is an exerpt I posted on my face book fresh from the call that explains the call fairly well:
    “Just got off the phone with Russell, He’s a higher up State KanCare employee. His office is right across the street from the Gov. This poor guy had to reap my orated whirlwind. This guy got it with no edits, or moderation. I gave him my full opinion, and plan of action. It was all recorded, and It will be given to the Governor to listen to. It’s not nice. They say I have to take their doctors. I say it’s a federal law that I get the doctor of my choice. He also mentioned that what they are
    doing has not yet been approved by the Feds. So at this point come January first, an illegal Medicaid system will be enacted in Kansas
    forcing all defenseless members to accept third world medicine. Straight from
    the horses mouth!”
    Besides telling me how illegal what they are doing probably is, he also insisted that I have to ask my doctors if they are going to sign up on the new KanCare. I explained how Cotton O’Neil doctors work for a company and draw paychecks, and have no clue or say what the company does. So, they aren’t about to tell me. IT’s a private company business. Somehow I couldn’t make him understand the concept that not all doctors are free lance and draw paychecks.
    Now thisperson “Russell” (Sorry I didn’t get his last name in the heat of the moment),had never heard of Cotton O’Neil either. There is a Cotton O’Neil Clinic. It’s Several blocks from the State Capitol.
    Russell is some big wig right hand man to the governor, a state official that is supposedto know something about KanCare, and the states recourses I would think. But he
    had no clue except to insist that no matter what I had to pick from one of the
    three third world policy’s and use their doctors. I argued my condition and how
    a new doctor would be a death sentence for me. He still insisted I had no
    choice until I mentioned the federal Law.

    That’s when he told me what a sham they are producing in so many words. I told him how I will refuse the new KanCare and appeal for my old Medicare and tie it up in courts for as long as possible. That I will go out of my to make a Gandhi style media stink. And informed him I will be going to the hospital instead of the doctor when I need treatment, and not their doctors, with the media. Then he told me the state would cover very little of that and the rest would have to written off by the hospital, in a carefree “Que Sera” tone. I told him If I actually did do this, I am so physically messed up my hospital bills would probably hit the 6 figures in six month or less. Then he tried a Jedi mind trick and informed me he was right across the street from the Governors office, like I should be scared of some hidden power he held. I was not impressed. So I told him that’s good, why don’t you just run this conversation right on over to him, it’s being recorded anyway. He said he would.
    After this ordeal I was left dumbfounded & wondering at what I can only describe as a Three Stooges operation..

    Now I am as worried about what kind of clueless airhead’s are running Kansas State Government, as I am my health.

  • Day 7 of the new plan has not been easy. None of our sons doctors are in the plan. None of his medications were set up. They did not show him as having a guardian and he cannot speak for himself, so I have to waith until they have the paper work filed that i will send them to prove I am his guardian. Meanwhile his medicines are not approved either.
    Tomorrow we will spend another 2-3 hours trying to sort this terrible mess out. We will see if we can even get him into a neurologist.