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As Deadline Nears, Kansas Still Waiting For Federal Approval Of KanCare Extension

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Kansas officials say there is little chance that more than 400,000 Kansans who depend on the state’s Medicaid program will see their services interrupted.

They say they are confident federal officials will approve a critical waiver request before an end-of-the-year deadline.

“We’ve met all the requirements, so I would expect approval to be coming very soon,” said Michael Randol, director of the division of health care finance at the Kansas Department of Health and Environment.

Kansas operates KanCare, its privatized Medicaid program, under a five-year federal “waiver” that allows three private managed care organizations to administer the program. Through waivers, states can make changes to Medicaid as long as they continue to cover required services and don’t increase federal costs.

State officials have asked the federal Centers for Medicare and Medicaid Services for a one-year extension of the waiver, which expires Dec. 31, so that they can design a new program for implementation in 2019.

Officials in the outgoing Obama administration rejected the waiver request, citing complaints from consumer groups and KanCare consumers about the state’s lax oversight of the managed care organizations. 

In May, the Trump administration approved a state plan to correct those problems, prompting expectations that it also would approve the KanCare waiver extension. 

Four months later, state officials are still waiting. But they’re not alarmed, Randol said.

“We have had several meetings with CMS and they have indicated that they are positive it will be approved,” Randol said.

In the meantime, work continues on what state officials are calling KanCare 2.0.

KDHE has scheduled a series of conference calls this month with participating health care providers and KanCare consumers to update them on changes in its contracts with the managed care organizations. 

The changes will address issues that providers and consumers raised at earlier meetings, Randol said.

“We have had several meetings with CMS and they have indicated that they are positive it will be approved.” — Michael Randol of KDHE

“We committed to providers and (KanCare) members that we would have this conversation with them to close the loop and let them know that we heard them,” Randol said.

The proposed changes will be included in a request for proposals that KDHE expects to issue in November, Randol said. The agency will then spend several months evaluating the responses it receives and negotiating new contracts with three to four managed care organizations.

“Our goal is to have contracts awarded by June of next year so if there were to be a change in MCOs that we have ample time to transition members,” he said.

KanCare provides health insurance to approximately 425,000 Kansans, mostly children in low-income families, people with disabilities and elderly Kansans who need nursing home care but can’t afford it.

At the urging of the Kansas Hospital Association and several other advocacy groups, state lawmakers approved legislation during the 2017 session that would have expanded KanCare eligibility to non-disabled adults with annual incomes up to 138 percent of the federal poverty level — $16,643 for an individual and $33,948 for a family of four.

However, Republican Gov. Sam Brownback vetoed the bill and lawmakers fell a few votes short of overriding the veto. 

Jim McLean is managing director of the Kansas News Service, a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio covering health, education and politics. You can reach him on Twitter @jmcleanks. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to kcur.org.

Jim McLean is a political correspondent for the Kansas News Service, a collaboration based at KCUR with other public media stations across Kansas. You can email him at jim@kcur.org.
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