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KanCare launch provides 'interesting' twist in 2013

12/31/2013

A look at some of the top stories from northwest Kansas in 2013.

By KALEY CONNER

kconner@dailynews.net

Jerry Michaud, president of Developmental Services of Northwest Kansas, could sum up the last year of health care in one word.

"Interesting," he said. "It's always interesting."

On Jan. 1, 2013, the state of Kansas launched a new Medicaid program, known as KanCare, and placed control of the low-income insurance program in the hands of three for-profit insurance companies. Those companies are Amerigroup, Sunflower State Health Plan and United Healthcare.

Gov. Sam Brownback's administration has promised the change will result in significant cost savings, and he announced in September the program had saved $37 million.

Skepticism remains throughout the health care industry, however, about how those savings are being achieved. The program's rollout was marred by reports of delayed payments, decreased reimbursement rates and difficulty getting timely approval for necessary services.

Some of those concerns are continuing. A small portion of DSNWK's services was rolled into KanCare last January. For a particular service, one company has paid only a 26-percent reimbursement rate for the entire year, Michaud said in mid-December.

The other two companies are paying approximately 80 percent.

"You just have to keep tenacity," Michaud said of dealing with delayed payments. "I hope that once we get past the newness of everything, that will settle into a smooth system. That's my hope."

As of that time, DSNWK only had signed a contract with one of the three companies. Contracts were supposed to be ratified within 90 days of implementation.

Michaud said he was hopeful contracts with the other two companies would be reached soon, but the company wanted to ensure the contracts were fitting with the community- and home-based service program for individuals with developmental disabilities.

All of developmental and intellectual disability services were set to be included in KanCare this Jan. 1, despite a statewide push earlier this year to carve the type of service out of the new program.

That changed at the end of 2013, when the federal Centers for Medicare and Medicaid Services last week recommended delaying implementation to allow further consideration of public comments, according to a press release from the state.

As of Dec. 27, state officials were hoping the concerns could be addressed in time for the program to take full effect in February for the IDD population.

Miner Family Dentistry in Hays is one of only two Hays dental providers accepting Medicaid. Staff there have experienced similar difficulties during the past year, said Dr. Melinda Miner, and the clinic has decided to drop one of the three companies next year.

The office no longer will be contracting with Sunflower State Health Plan. Miner said her staff sent letters in October advising patients of the change and is urging patients who want to stay at the clinic to switch policies.

"It's not that we don't want to see those patients," she said. "It's that we don't want to deal with that company anymore."

Delayed payments, denial of services supposed to be covered and excessive paperwork are among Miner's complaints.

"It's become a paperwork nightmare," she said. "I finally got tired of it and told them, 'If I wanted to sit and do paperwork all day, I wouldn't have become a dentist.' "

First Care Clinic is the other dental provider in town that accepts Medicaid. Miner Family Dentistry accepts only children with Medicaid coverage.

That so few dental providers in the Hays area accept Medicaid is nothing new. Dentists long have been weary of the program due to low reimbursement rates, Miner said.