Kan. seeks Medicaid waiver from feds

TOPEKA, Kan. (AP) -- Kansas has formally asked the federal government for permission to overhaul Medicaid, applying for a waiver of rules that would impede Gov. Sam Brownback's efforts to turn the state's entire $2.9 billion-a-year program over to private, managed-care companies.

Brownback's office declined Friday to discuss its waiver application until an afternoon news conference. But the federal Centers for Medicare and Medicaid Services confirmed for The Associated Press that it received the application Thursday.

The conservative Republican governor plans to turn the state's Medicaid program -- which covers health care for the poor, disabled and elderly -- over to three companies, starting Jan. 1, 2013. The administration expects to issue contracts this summer, though it has promised to delay including long-term services for the developmentally disabled in the overhaul until Jan. 1, 2014.

The federal government must approve some changes because it provides a majority of the funds for states' Medicaid programs. Brownback's administration said in February that it would seek a waiver of some rules to allow its overhaul to go forward, as well as a "global" waiver of all rules to allow further changes later.

Neither the federal centers nor the governor's office released a copy of the application before an expected Statehouse news conference by Lt. Gov. Jeff Colyer, a surgeon who led the team that developed the Medicaid overhaul plan. But the administration previously has said a federal waiver is necessary to cover all Medicaid participants in a managed-care program.

The centers are part of the U.S. Department of Health and Human Services, and its secretary, Kathleen Sebelius, is a Democrat who previously served as Kansas governor.

Most of the 387,000 Kansans receiving state medical assistance are covered by managed care through private contractors, but the Medicaid overhaul represents the first time the state has tried to include relatively expensive, long-term care for the disabled and the elderly, including those in nursing homes.

The administration argues the overhauled Medicaid program -- to be called KanCare -- will better coordinate care for participants, improving their long-term health. The administration also projects the overhaul will reduce the state's costs and savings are crucial because the federal government, facing its own budget problems, is likely to cut its Medicaid funding.

But advocates for the developmentally disabled have been vocal critics of the overhaul. Their concerns led Brownback this week to endorse a proposal from state House Majority Leader Arlen Siegfreid, an Olathe Republican and normally an ally of the governor, to delay including long-term services for the developmentally disabled in the contracts, while permitting pilot programs.

Critics worry the overhaul will insert an extra layer of bureaucracy between disabled Kansans and service providers, noting many clients receive long-term services that don't resolve medical issues but help them live as independently as possible. Many don't trust assurances that private companies won't be allowed to cut services or payments to service providers.


Centers for Medicare and Medicaid Services: http://www.cms.gov/

Kansas governor: https://governor.ks.gov

John Hanna can be reached at www.twitter.com/apjdhanna