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Panel questions Kansas health care system changes

12/6/2013

TOPEKA, Kan. (AP) -- Two days of hearings in Kansas by a national health care oversight panel raised questions about the implementation of the state's KanCare system and the impact on Medicaid services.

TOPEKA, Kan. (AP) -- Two days of hearings in Kansas by a national health care oversight panel raised questions about the implementation of the state's KanCare system and the impact on Medicaid services.

Members of the National Council on Disability -- which advises the president and Congress on health care issues -- on Thursday questioned changes in how services are provided to the disabled under KanCare. The Wichita Eagle reports (http://bit.ly/IOIQ3O ) that the panel asked Kansas officials to explain why some residents no longer qualified for services.

Gary Blumenthal, a former Wichita legislator and social services official, questioned how services could be reduced under the state's new managed-care system.

Kansas privatized Medicaid services in 2012. More changes are in store starting Jan. 1, 2014, when KanCare begins taking over management of daily living services for the developmentally disabled.

Blumenthal asked if KanCare was using lower standards to make decisions about the quality of care for program participants.

One example of changes was presented by Finn Bullers, who suffers from diabetes and muscular dystrophy, and who relies on a respirator 24 hours a day and a wheelchair to move around. Bullers will receive fewer hours of attendant care each week under the new KanCare management.

Shawn Sullivan, secretary for the Department for Aging and Disability Services, said the changes were related to how service levels were approved under the new managed-care model.

"The difference is pre-KanCare, those weren't always followed and post-KanCare, they are," Sullivan said. "Essentially the standard is the same; it's carried out by different people."

Sullivan said the old system had the potential for conflict of interest because service providers were determining the level of care.

Blumenthal, who was director of the Wichita social services office from 2003 to 2005, disagreed.

"My experience as a former SRS director was that SRS employees were very consistent and respectful of the manner in which they made decisions," he said.

Critics of the KanCare system told the council that the goal appeared to be to cut $1 billion at the expense of services. They are lobbying federal regulators to deny a waiver sought by Kansas to implement the changes.

Sullivan said the agency was trying to curb the growth in health care costs, not reduce services.

But Tom Laing, director of Interhab, an association for the developmentally disabled and service providers, said KanCare was more about managing costs, not care. He argued that cuts in services were a result of tight budgets caused by income tax cuts enacted in 2012.