- Associated Press - Thursday, January 30, 2014

TOPEKA, Kan. (AP) - Kansas is moving ahead with the last piece of overhauling its Medicaid program after receiving federal government permission to turn over management of in-home services for the developmentally disabled to private health insurance companies.

The changes state officials announced Thursday will take effect Saturday and affect about 8,500 people receiving services aimed at allowing them to live independently, including health monitoring and help with daily tasks, employment, and financial management. The state’s Medicaid director received approval from a U.S. Department of Health and Human Services administrator in a letter dated Wednesday.

The $3 billion-a-year Medicaid program provides medical coverage for about 345,000 poor and disabled Kansans, and last year, the state turned administration of most of the program over to three private health insurance companies. Republican Gov. Sam Brownback contends participants in the overhauled program - now called KanCare - are getting better services, with less cost to the state.

Federal officials were required to sign off on the overhaul because the federal government provides a majority of funds for states’ Medicaid programs.

Advocates for the developmentally disabled have been vocal critics of KanCare, and their concerns prompted the state to delay the last piece until this year. Brownback’s administration had planned to have the final changes in place in January, but HHS officials didn’t grant their approval in time.

Brownback predicted in a statement that developmentally disabled Kansans will see improved care, and Lt. Gov. Jeff Colyer, a reconstructive plastic surgeon who often serves as the administration’s spokesman on health issues, called HHS approval “monumental” for the disabled.

“We believe they will have better health outcomes and better lives,” said Angela de Rocha, a spokeswoman for the state Department for Aging and Disability Services.

But advocates for the developmentally disabled remain skeptical. Some hospitals complained last year about delays in payments under KanCare, and critics of the overhaul have questioned whether some participants are receiving lesser services, despite assurances from the companies and the administration say more is being covered through their contracts.

Tom Laing, executive director of InterHab, which represents service providers, said HHS approval suggests developmentally disabled Kansans’ needs became less important than “the interests of the bureaucrats in Topeka and Washington.”

“We think this is going to set back services for the developmentally disabled,” Laing said. “We hope we’re wrong.”

The HHS letter Wednesday said the federal agency’s approval comes with a requirement that the state address a list of about 1,700 developmentally disabled Kansans who are seeking additional services. A regional HHS administrator identified the list as a key issue in a letter to the state in December, and state officials now say they intend to eliminate the list within several months.

The HHS division overseeing Medicaid also provided the state with a 106-page report outlining special conditions coming with its approval. They include calls with state and federal officials every other month for monitoring KanCare.

Brownback and other officials in his administration have said repeatedly that the state’s existing network of providers will continue to bring services to the developmentally disabled and that individuals and families won’t have to change them.

“There will be no radical changes in services,” de Rocha said.

But Laing said the system will become more complex for developmentally disabled Kansans and their families because the private companies represent a new layer of bureaucracy for them to navigate.

In June 2012, Brownback’s administration awarded Medicaid-management contracts to Kansas subsidiaries of Amerigroup, based in Virginia Beach, Va.; Centene Corp., headquartered in St. Louis, and United Healthcare, based in Minneapolis.

Laing said, “Our folks are going to work hard to make it work, no matter what happens.”



Brownback administration site on Medicaid overhaul: https://1.usa.gov/Lu0RpC

InterHab: https://interhab.org/main/

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