Medicaid

TOPEKA, Kansas — Dozens of primarily elderly or disabled Kansans lost their Medicaid coverage because of errors made by Aetna. Staff at the state health department discovered the problem, restored their insurance and stopped further cancellations.

Months later, state workers are still double-checking the work of Aetna Better Health — one of the three companies that helps run the state’s privatized Medicaid system — while Aetna puts together a permanent fix.

The question of whether to expand Medicaid and extend health insurance to thousands of Oklahomans promises to be a major topic over the next year.

The Healthcare Working Group, a bipartisan legislative committee charged with deciding whether to endorse Medicaid expansion or other policy moves, kicked off its work last week and is expected to unveil recommendations before next year’s session. Meanwhile, a signature-collecting drive is underway to put a state question on a 2020 ballot to accept expansion.

Aetna Better Health is struggling to keep its Medicaid contract with KanCare, to the point that state officials found fault with Aetna’s recent plan to improve services.

But Kansas lawmakers had two words this week for the company: Keep trying.

TOPEKA — Aetna is bringing in new leadership to run its Medicaid operations in Kansas after chronic complaints from hospitals and others put it at risk of losing its contract.

The Kansas Department of Health and Environment confirmed Friday that Aetna Better Health of Kansas CEO Keith Wisdom is no longer in that role. But the insurer declined to answer questions about whether it had replaced Wisdom.

TOPEKA ― State officials have told one of the key players in Kansas’ privatized Medicaid system that it stands in danger of getting fired for not living up to its contract.

Aetna Better Health has until Wednesday to tell state officials how it is addressing chronic complaints about delayed payments to hospitals and other problems.

A formal letter from the state to Aetna says failure to fix the problems so far means the company’s contract “is in jeopardy of being terminated for cause.”

Laura Robeson quit her job as a fourth-grade teacher to care for her son, who has cerebral palsy and other health problems. But as politicians considered cuts to various health care programs, she felt compelled to become an activist, working with others to speak out for families like hers.

That culminated at the State of the Union Address in February. Kansas Congresswoman Sharice Davids chose Robeson to attend as her guest, providing a real-world example of the role federal healthcare policies play in a citizen's life.

Kansas can no longer put off care for Medicaid patients with hepatitis C because of a recent legal settlement. But hundreds of the state’s prison inmates not covered by that lawsuit will have to wait another year for the pricey treatment.

Kansas Democratic Gov. Laura Kelly’s Medicaid expansion proposal is a retread.

It’s virtually the same bill that former Republican Gov. Sam Brownback vetoed in 2017.

An attempt to override that veto in the House failed, but only by three votes.

This year the Trump Administration said it would support states imposing “community engagement” requirements on Medicaid. That means, for the first time in the program’s history, states can require people to work a certain number of hours to be eligible for the government health program for low-income Americans.

Kris Kobach says his proposal to reform Kansas Medicaid could save the state $2 billion.

At campaign events, the Republican nominee for governor touts the benefits of combining Medicaid with direct primary care, an unconventional payment system that avoids the bureaucracy of health insurance.

A contract dispute that could disrupt the health care of more than 400,000 Kansans enrolled in the state’s privatized Medicaid program has landed in court.

Amerigroup, one of three companies that since 2013 has managed the delivery of care to low-income, elderly and disabled through KanCare, is contesting a recent decision by state officials to replace it with Aetna when new contracts take effect in January.

Kansas has agreed to settle a lawsuit alleging the state’s Medicaid program sets too many barriers for hepatitis C patients to receive potentially life-saving but expensive medications.

Terms of the settlement have yet to be finalized, but the parties filed a notice with the court Tuesday afternoon that they had resolved the case after mediation. 

Kansas Gov. Jeff Colyer says he will continue to push for a Medicaid work requirement despite a recent court order blocking a similar policy in Kentucky.

Last week, U.S. District Judge James Boasberg, an Obama appointee in the District of Columbia, questioned whether the Trump administration had adequately considered the consequences of Kentucky’s work requirement before reversing longstanding federal policy to approve it.

Kansas Gov. Jeff Colyer’s proposed Medicaid work requirement would create a “catch-22” for some low-income Kansans, according to a report released Tuesday.

The report, from the Center for Budget and Policy Priorities — a nonpartisan research organization that supports Medicaid expansion — said work requirements could jeopardize their coverage.

Five-year-old Ridley Fitzmorris sits at a picnic table in his backyard in Lawrence, one leg dangling and the other tucked beneath him. His eyes are focused on a row of Hot Wheels that his therapist asked him to count.

“One, two, three,” he says in a whisper, his finger hovering over each toy car until he reaches the last one. Turning to an iPad that he uses to communicate, he clicks an icon. “Eight,” the computerized voice announces.

“Good job!” cooes therapist Ashley Estrada, a specialist in treatment for children with autism. “You did it by yourself."

Public health experts in Texas are concerned that a growing number of American children are forgoing services like Medicaid and food stamps because their parents are undocumented. The trend could get worse, they say, if a proposed change to immigration policy goes through.  

Kansas lawmakers have struck a deal to end their session-long battle over Republican Gov. Jeff Colyer's plan to tighten eligibility for KanCare, the state’s privatized Medicaid program.

The compromise, detailed in the final budget bill of the 2018 session, blocks Colyer from implementing a work requirement and lifetime benefit cap as part of his planned “KanCare 2.0” makeover of the program. 

High Plains Morning thanks Lisa Hancock from the  Area Agency on Aging of the Panhandle  for stopping into the studio today to share information about their 2018 Older Americans Month Celebration: Engage at Every Age.

Here are the details!

WHEN:            

May 4, 2018

9:00 a.m. to 3:00 p.m

***Registration check in opens at 8:30 a.m.***

 --FREE EVENT!

A behind-the-scenes struggle over proposed changes to Kansas’ Medicaid program is coming down to the wire.

Republican Gov. Jeff Colyer has offered concessions. But he appears determined to stick with his proposal to make some non-disabled recipients work, or undergo job training, for their health care coverage.

Jon Hamdorf, the Kansas Department of Health and Environment official who oversees the state’s privatized Medicaid program known as KanCare, said the governor believes “very strongly that work is a pathway to independence.”

This story was updated at 4:12 p.m. to include the comments of Planned Parenthood Great Plains' president and CEO.

Kansas improperly sought to end Medicaid funding for Planned Parenthood, a federal appeals court ruled Wednesday, rejecting the state's claims that the organization illegally trafficked in fetal parts and committed other wrongdoing.

The Kansas Medicaid program sets too many barriers for patients to receive a potentially life-saving, if extremely costly, drug regimen, a lawsuit filed Thursday contends.

The class action filed in federal court argues that KanCare should cover the cost of medications that have proven effective in treating hepatitis C without subjecting patients to a lengthy list of conditions.

When Kansans on Medicaid are incarcerated or treated at residential mental health facilities, their Medicaid benefits are terminated. Mental health advocates hope to change that during the upcoming legislative session by pushing for a bill that would instead suspend those benefits.

When Kansans on Medicaid are incarcerated or treated at residential mental health facilities, their Medicaid benefits are terminated. Mental health advocates hope to change that during the upcoming legislative session by pushing for a bill that would instead suspend those benefits.

After patients or inmates are dropped from Medicaid, it can take weeks or months to reinstate health coverage — a risk for people who need continuous care for mental health conditions.

Republican legislators have temporarily sidetracked an effort to block the Brownback administration from obtaining federal approval to renew KanCare, the state’s privatized Medicaid program.

Democrats on a joint committee that oversees KanCare wanted the panel’s report to the full Legislature to recommend keeping the current program in place until a newly elected governor takes office in January 2019.

CCO License

There’s a growing problem with Medicare prescription drug coverage for seniors who take high-priced specialty drugs: there’s no cap on how much they pay.

As The Denver Post reports, each prescription drug plan is structured a little differently, but people with very high drug costs almost inevitably enter what’s called the “catastrophic” phase of coverage. Then, they pay 5 percent of the list price of their drug, which is no small sum in an age of $10,000-a-month cancer drugs

President Trump has pledged to not make cuts to Medicare, the federal insurance program for seniors, but Seema Verma, administrator of the Centers for Medicare and Medicaid, acknowledges that changes are needed.

One of the program’s main funds, the Hospital Insurance Trust Fund, is expected to be depleted in 11 years.

On Monday, Verma was in Olathe, Kansas to talk with seniors about Medicare and encourage them to take part in Medicare open enrollment, which runs from October 15 through December 7.

State Medicaid officials on Friday formally started the process of renewing KanCare, the privatized Medicaid program launched by Republican Gov. Sam Brownback in 2013.

The two state agencies that oversee the private contractors that manage the program released a draft of the plan they intend to submit for federal approval after a public comment period that runs through November.

The federal agency that oversees Medicaid has agreed to a one-year extension of Kansas’ $3.2 billion KanCare program, which provides managed care services to the state’s Medicaid population.

The overhaul of the Kansas computer system for processing welfare and Medicaid applications recently went through its final implementation phase. State officials say the process went smoothly, especially compared to the system's initial rollout that delayed thousands of Medicaid applications.

$1.25 million.

That’s the size of the bill that could have shuttered the only public hospital in rural Pemiscot County, Missouri in August 2013.

$750,000 for payroll. $500,000 for a bond payment. $1.25 million total. One August day in 2013, the hospital’s CEO Kerry Noble had to face facts: The money just wasn’t there. It took an emergency bailout from a local bank to keep their doors open. For now.

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