Governor hopefuls want power to change KanCare. Colyer official says they’ll have it

By Jonathan Shorman, August 20, 2018

Topeka-Kansas Gov. Jeff Colyer just lost his primary election, but he’s still moving forward with new Medicaid contracts that could affect more than 400,000 residents.

The man who defeated Colyer, Republican nominee Kris Kobach, said he doesn’t want Colyer to hamper him from making changes if he becomes governor. Sen. Laura Kelly, the Democratic nominee, and independent Greg Orman also are planning reforms if they win.

Colyer’s top Medicaid official said Monday the next governor will have flexibility to change the program, which provides care for children, pregnant women, low-income individuals and the elderly along with services for Kansans with disabilities.

Colyer conceded defeat last week in the Republican primary for governor, but his administration reiterated it will move forward this fall with new contracts for insurance companies to operate KanCare, the state’s privatized Medicaid program. The contracts are set to go into effect in January as Colyer leaves office.

But many of those changes, including work requirements, will not go into effect immediately. State Medicaid director Jon Hamdorf said the administration is holding off because lawmakers voted this spring to require legislative review of significant changes.

“I felt that you did not want me to lock us into a long-term contract, you did not want me to implement expensive parts of the program and you did not want me to do work requirements. All of those things are gone,” Hamdorf told lawmakers during a hearing Monday.

Kobach, the secretary of state, said contracts that have already been awarded should be honored, but said he is planning his own changes, including launching a pilot program to allow patients to pay their doctor $50 a month for unlimited primary care visits.

“Therefore, I am hopeful that the current administration will not tie the state down for an extended period of time in a manner that would delay these reforms,” Kobach said in a statement.

Kelly has said she would ultimately move the state away from a for-profit Medicaid system and that she wants to expand Medicaid. She indicated on Monday that she wants changes to be smooth if she wins.

“I can tell you I will not do anything drastic to make an ideological point. First and foremost thing on our mind has to be the people receiving the services,” Kelly said. “So if we’re going to change things, I will want to make sure we have a transition plan in place that ensures people have continuity of service throughout and there’s no gap.”

Independent Greg Orman has said providers that serve customers better and get results at lower costs should be rewarded with more business. He also wants to create incentives for KanCare recipients to stay healthy and expand Medicaid.

“I think any Governor would like to have a clean slate as it relates to a program as important as KanCare. With that said, I wouldn’t want any delay in implementing contracts to affect recipients,” Orman said in a statement.

The Colyer administration told lawmakers the new KanCare contracts will provide flexibility to the next governor to make changes to the program. The new contracts will last three years, with the option for one-year renewals.

The length means the contracts will not automatically last beyond the governor’s four-year term. Officials also said the contracts allow for the contracts to be terminated early.

“All of them can be terminated at any point in time. We can amend things. We can change things. So there is flexibility,” Hamdorf said.

The administration in June chose Sunflower State Health Plan, UnitedHealthcare and Aetna as for new KanCare contracts will begin in January. The managed care organizations provide services for a flat rate per person rather than charging for each service provided.

Current provider Amerigroup was left off the list, and has is challenging the fairness of the bidding process in court. A district court judge has declined to stop the new contracts from moving forward while Amerigroup’s case is litigated.

KanCare, launched in 2013, was Colyer’s signature accomplishment as lieutenant governor under Gov. Sam Brownback. He spearheaded the program’s creation with the intent to transform Medicaid and improve patient health while controlling costs.

Colyer and other program supporters say the change has saved at least $1.7 billion — though that figure is disputed — and that access to preventative care has improved. Patient advocates remain unsatisfied and point to a number of problems since the launch.

Earlier this year, Kansas found that the company tasked with processing Medicaid applications wasn’t fulfilling its contract. The state put the company, Maximus, on an improvement plan but said it didn’t fully meet a June deadline to shape up.

Jeff Andersen, secretary of the Kansas Department of Health and Environment, said Monday that the state will not sue Maximus.

State auditors tried to assess this spring whether KanCare had improved health outcomes for participants, but found that data about the program was so incomplete they couldn’t make an overall judgment. At the time, KDHE expressed concerns with how auditors arrived at their conclusions.

Andersen said the release of the audit played a role in the decision not to sue.

“I wouldn’t want to go into a court of law and try to win a case when our own team is saying our data is not credible,” Andersen said.

He said the auditors’ conclusions may be right – or they may be wrong. There’s a lot of other factors to consider, he told lawmakers, though he didn’t elaborate on the factors.

“It’s dangerous then if you’re going to go out and the findings, these conclusions are going to be made public, which is in fact what happened,” Andersen said.

Contributing: The Kansas City Star’s Andy Marso

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