Providers Urged to Move Quickly on KanCare Contracts for DD Services

About 150 people showed up Thursday in Olathe for an informational meeting on services for developmentally disabled Kansans in the state's revamped Medicaid program.

OLATHE – Submitting contracts to the KanCare managed care companies is a big step Medicaid providers can take now to smooth the transition of their developmentally disabled clients into the system come Jan. 1, Kansas officials said Thursday.

“That is just super important,” said Kim Brown, director of managed care at the Kansas Department for Disability and Aging Services.

Her comments came at an informational meeting about the state’s revamped Medicaid program in anticipation of its scheduled expansion.

Effective Jan. 1, the state plans to moving nonmedical services for the developmentally disabled, into KanCare, a managed care system run by three for-profit insurance companies under contract to the state.

Thursday’s provider meeting drew about 150 people at Olathe City Hall. A second meeting later in the day for consumers drew about 90 people.

Some providers said that the complexity of the contract language was making it difficult for them to submit the document.

“I should be able to understand what it is I’m signing without having to hire an attorney to interpret it,” said Susan Jarsulic, board president of Dreams Work, an adult day program in Lenexa.

For example, there was one specific question about a contract, she said, that two KanCare company representatives at the meeting were unable to answer.

Thursday’s meetings were the last of an “education tour” undertaken this week by state officials to talk about the full inclusion of the developmentally disabled in KanCare. The previous meetings were in Hays, Wichita and Parsons.

Virtually all the state’s other Medicaid enrollees already are in KanCare, which was launched by the administration of Gov. Sam Brownback earlier this year.

Brownback officials estimate the new program will reduce the growth in federal and state Medicaid spending in Kansas by $1 billion over five years.

Providers, however, continue to experience delays in payments from the managed care organizations.

Advocates for persons with developmental disabilities have argued throughout the run-up and implementation of KanCare that nonmedical services are ill suited for commercial managed care plans. Those services can include everything from help with a job to a daytime activities center.

Earlier this month, advocates for the developmentally disabled gathered in Olathe to express concern about full inclusion. Speakers expressed a number of concerns with administrative and medical decisions made by the managed care organizations.

At the meeting Thursday, Brown told the providers the state is still working on how to integrate individual clients’ plan of care into the KanCare system and how to make it work with existing case managers.

“We are right in the process of working through that,” she said.

The state is running a transition project with about 500 participants to prepare for integrating nonmedical developmental disability services into KanCare.

Stephanie Rasmussen, an official with Sunflower State Health Plan, one of the managed care organizations, offered an example of how case management was working in the transition project.

She said Sunflower paid for a new behavioral assessment for one hard-to-serve client who had been hospitalized two times in two months for psychiatric issues. That allowed the client’s provider to create a behavioral support plan that has so far prevented any re-hospitalization for psychiatric care.

Providers also have expressed concern about a shift in billing through KanCare, which will pay in 15-minute increments versus the longer timeframes for service periods used now. Providers now bill for full or partial days.

Brown said that does not mean providers have to document services for every 15 minutes. She said it’s just a new way to administratively track services.

She said the change was needed, in part, in order to work with the KanCare companies’ computer systems. She also said it would help combat fraud in the program.

Another issue state officials are working to resolve, said Aquila Jordan, director of the home- and community-based service programs for KDADS, is how case managers request additional billable time from the state under KanCare.

At present, the case managers can make such a request once a year, she said.

In moving to KanCare, Jordan said, the state is working with case managers to see how the state can improve that process.

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