By Dave Ranney, KHI News Service, December 08, 2010
TOPEKA — Several members of the Joint Health Policy Oversight Committee on Wednesday lashed out at the Kansas Health Policy Authority, accusing its leaders of misinforming or confusing legislators.
"The health policy authority is just frustrating the heck out of us," said Rep. Brenda Landwehr, the Wichita Republican who chairs the committee. "The health policy authority was started for a reason – so that we would get good information, but we’re not getting that information."
"This disturbs me," Rep. Bob Bethell, R-Alden, told agency officials. "We don’t want to hear what you think we want to hear, we want accurate information."
Confusion over drugs
Committee members became upset when LeAnn Bell, senior pharmacy manager at the agency struggled to explain how much money could be saved if the state limited Medicaid beneficiaries to two, brand-name prescription drugs rather than five. The health policy authority oversees the state Medicaid program.
Initially, health policy authority officials noted that a similar move appeared to have saved Oklahoma’s Medicaid program about $12 million. But they then qualified that statement with various caveats that left legislators apparently convinced they were hearing double-speak.
For example, Bell said a 2008 study had found that 68 percent of the Medicaid-funded prescription drugs in Oklahoma were generics. In Kansas, the rate was 64 percent. Later numbers, she said, appeared to put Kansas’ rate at 67 percent.
She told committee members that while Kansas and Oklahoma’s percentages for generic drug use were similar, several factors – lower rebates from drug manufacturers, primarily – were likely to reduce the $12 million savings described in agency documents given to the committee.
In short, Bell said that while limiting Medicaid prescription drugs would likely save money, it was difficult to predict how much.
Sen. Vicki Schmidt, R-Topeka, wondered aloud if Bell was trying to confuse committee members by citing data from 2008 and 2010.
"I’m a pharmacist and I don’t understand what you’re saying," Schmidt said.
Bell said she didn’t want committee members to think there would be a $12 million savings that may not materialize.
"You work for us"
But Bethell and Landwehr said they were expecting the health policy authority to say how much could be saved.
"I know for a fact that isn’t the first time you guys have been told this," Landwehr said, referring to lawmakers' request that the agency provide a number on projected savings.
"I would highly suggest that you not show up before the (House) Health and Human Services Committee (another committee also chaired by Landwehr) without the information in hand that’s been requested," she said. "You work for us."
Sen. Laura Kelly, D-Topeka, urged health policy authority officials to find a better way to explain the agency’s budget issues.
"Health care issues, I think, are confusing enough as it is," she said. "But the way you make your points makes it even worse. It comes across as a lot of gobbledygook."
Bell, state Medicaid Director Barb Langner, and health policy authority Executive Director Andy Allison, apologized for the confusion.
The agency has been under fire from legislators for several months. Some have called for reorganization of the health policy authority, saying its quasi-independent governance board should be abolished with agency officials made directly answerable to the governor like other state executives.
Landwehr later told KHI News Service that her criticism of the agency was “a separate issue” from the governance issue.
"As far as I’m concerned that’s not what this is about," she said. "This is about us getting good information."
Brownback hearing complaints
But Bethell said he intends to be first in line to introduce a bill that puts the governor in charge of the health policy authority.
"Unless somebody beats me to it, that’s the plan," he said.
Governor-elect Sam Brownback was in the Statehouse on Wednesday and spoke briefly with KHI News Service about the agency.
"I am hearing a number of complaints about it, structurally – and I’m hearing those concerns consistently," he said. "In fact, I haven’t run into anybody who likes the structure of it."
Asked if he would push for making the agency part of his cabinet, he replied: "I’m not ready to make an announcement on that."
In other action Wednesday, the oversight committee:
The committee is scheduled to meet again Thursday. Members will hear from a representative of the Juvenile Justice Authority and the executive director of the Kansas Association for the Medically Underserved. They also are scheduled to hear testimony about the shortage of Medicaid dentists.