KanCare forum focuses on failings
By MATTHEW KENWRIGHT
Approximately a dozen community members attended a Saturday forum on KanCare at Fort Hays State University to discuss the state's new Medicaid program and its perceived shortcomings.
The session was part of the National Alliance on Mental Health's annual conference. A consumer advocate, a health care provider and the program's ombudsman made up the three-person panel.
Rick Cagan, executive director of NAMI Kansas and event moderator, said KanCare is an experiment because the state government is outsourcing its Medicaid operations to three for-profit insurance corporations.
"We purposely call this an experiment because it's supposedly a demonstration of how we can provide a better level of care for individuals who are enrolled in Medicaid and spend less money," Cagan said.
The testimony shared suggested KanCare has struggled following its January debut. Undefined rules about prior authorization for prescriptions, reduced services, delayed payments to providers and general confusion are some of the program's growing pains.
Teresa Beaudry, Deerfield, attended the meeting and said she has a 33-year-old daughter with disabilities. There was miscommunication about prescription orders after KanCare was implemented, Beaudry said.
"She had been receiving medication for allergies, and all of a sudden she couldn't get it anymore," Beaudry said. "The pharmacy told us the insurance wouldn't pay for it anymore, and we had to do a bunch of calling around. We found out it has to be pre-authorized by the doctor."
Beaudry also said she is anxious because she heard rumors case managers for disabled patients might be changed. Her daughter is comfortable with her current manager and will find it difficult to communicate over the phone with a new one based in Topeka or Wichita, Beaudry said.
James Bart, the ombudsman who acts as an arbiter between KanCare parties, said the reality of reduced services is unavoidable. The problem is not unique to KanCare, he said.
"No reduction in services is a talking point. It's not a reality," Bart said. "I would look to the intellectual/developmental disabilities waiver services. There are currently about 500 consumers who have had plans of care revised or reduced by the managing care organizations."
The I/DD waiver, the program that assists people with disabilities as they go about their daily lives, will be included in KanCare in 2014, Bart said.
Amy Bird of High Plains Mental Health Center in Hays said her office is seeing a 15 percent to 20 percent increase in delayed payments from the managing care organizations.
"If the providers aren't being paid, we can't pay people to meet the needs," Bird said.
Sean Gatewood, community outreach manager with the Kansas Health Consumer Coalition, said his nonprofit wants the state or the managing care organizations to share more information about KanCare's development and progress.
"We're concerned that we don't get enough specific data out of the system to tell where there are problems," Gatewood said.