The following is an excerpt from the August newsletter of the Harvey-Marion County Community Development Disability Organization and highlights important information about KanCare.
KanCare updates – After the busy legislative session, you may be wondering what is happening with KanCare, the plan to convert Medicaid into managed care.
January 1, 2013 start date still planned. State of Kansas is still planning to implement KanCare on January 1, 2013, for all services paid for by Medicaid – including doctors, specialists, clinics, hospitals, pharmacies, mental health services, nursing facilities, home health services, optometrists, non-emergency medical transportation, and more – with the following important exception:
Exception: One-year delay for HCBS DD waiver and DD case management. HCBS DD waiver and DD case management are delayed from KanCare for one year. The one year starts from when KanCare actually starts, in event of delay.
Federal approval still needed. State of Kansas still needs to obtain approval from U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), in order to convert Kansas Medicaid into managed care. This approval is required because medicaid program funding is a state/federal match, with the majority of the funding coming from federal dollars. The way Kansas requests this approval is through a new Medicaid waiver called an “1115 waiver.” State of Kansas plans to submit the 1115 waiver application in August. State of Kansas is planning that CMS will approve its 1115 waiver application, that vendors and networks and billing systems will be ready, and that KanCare will start on January 1, 2013.
Three Managed Care Organizations (MCO’s) chosen. All three MCO’s selected by State of Kansas have set up offices in Kansas. Their names and headquarters are:
- Sunflower State Health Plan (Centene, of St. Louis, MO)
- Amerigroup Kansas, Inc. (Amerigroup, of Virginia Beach, VA; just purchased by WellPoint, of Indianapolis, IN, on July 10, 2012)
- United Healthcare of the Midwest (of Minnetonka, MN)
Enrollment/Assignment. This fall, every person who has a medicaid card will be automatically enrolled in, or assigned to, one of the three plans. You will find out by mail. This is planned to happen in November, 2012. Watch your mail!
What about choice? You will have 45 days to decide whether you want to stay with the MCO you are assigned, or whether you want to choose a different one. The 45 days start counting on the first day that KanCare starts. After the 45-day time frame is up, you will be locked in to that MCO for one year.
Choosing your plan. You will have opportunities to learn more about the MCO’s and ask questions. It will be important to choose a plan that covers your preferred doctors, specialists, and pharmacy. Each MCO is also developing its own menu of “value-added” covered services. You will be able to look at these lists to see which “value-added” services might benefit you the most. One value-added service that all three MCO’s will provide is adult preventative dental care.
Educational Sessions. State of Kansas has begun educational sessions around the state about KanCare and the three MCO’s. Representatives of the three MCO’s, Sunflower, Amerigroup, and United, are at the sessions. There are sessions specifically for medicaid providers, and sessions for people who have medicaid coverage and their families/guardians. The closest sessions have been scheduled for Wichita and Salina. Enclosed are handouts from the sessions.
More sessions coming. There will be sessions the last two weeks in August that focus on people who receive waiver services, and waiver service providers. Exact dates and locations are yet to be announced. Watch your mail! More sessions are scheduled for September 10 – 13 and again in October 2012.
Learn more online: http://www.kdads.ks.gov/KanCare/Medicaid_Reform.html
KHI News Service: http://www.khi.org/news/news/
Email: KanCare @kdheks.gov