Amid reports of possible corruption and complaints of long waits for benefits have come calls for an investigation into the Medicaid privatization program championed by Kansas Gov. Sam Brownback (R).
KanCare was launched in January 2013, when the state’s traditional Medicaid program was phased out. In its place the Brownback administration contracted three for-profit health insurance companies to coordinate health care for more than 360,000 low-income residents.
The Kansas Department of Health and Environment (KDHE) and the Kansas Department for Aging and Disability Services (KDADS) manage and provide oversight for KanCare.
When the proposed reforms to the state’s Medicaid program were first announced, the Brownback administration claimed that it would save $12.5 million the first fiscal year and a total of $367 million over the next five years.
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The administration approved contracts with three managed care companies: Amerigroup Kansas, United Healthcare Community Plan, and Sunflower Health Plan.
However, over the past year and a half, all three companies lost money. In 2013 the three companies lost a total of $110 million, and in the first half of this year the companies lost another $72.6 million. Opponents of the program are now growing concerned that if any of the three companies were to withdraw from KanCare, it could cause a significant disruption in service.
Delays in reimbursement payments to health-care providers have also been reported.
A report by the Kansas Department of Health Environment showed that none of the three companies handling the state’s Medicaid rolls met benchmarks for timely processing of claims in 2013. The goal of having all “clean” claims, those that do not include any errors or other processing problems, completed in 20 days and all claims completed in 60 days, were not met by any of the three companies during any month last year.
In September, Democrats on the KanCare Oversight Committee called for the appointment of a separate committee to determine whether any legal or ethical boundaries were crossed when Brownback approved contracts with the managed care companies.
The calls came after reports of an FBI investigation into possible corruption in the Brownback administration’s approval of the $3 billion KanCare contracts. Former Brownback chief of staff David Kensinger, who is an adviser to the governor’s campaign, is reportedly at the center of an FBI investigation, amid allegations that he received financial compensation from all three companies.
At least one of the three companies has publicly denied the allegation.
Brownback’s opponent in the gubernatorial election, state Rep. Paul Davis (D-Lawrence), told reporters at a recent campaign event that the program needs increased oversight.
“I am hearing lots and lots of complaints all across the state from nursing homes, hospitals, physicians, home health agencies about claims being denied, claims being not paid, claims being paid very late,” Davis said. “It’s causing a lot of cash flow problems for health care agencies across the state. I think this is further proof that this is just not working very well.”
Residents shared their experiences with the program at a forum sponsored by Kancare DD Watch, a watchdog organization that monitors the KanCare program. Many discussed the difficulties that those with disabilities have had in dealing with the system, according to reporting by the Wichita ABC-affiliate KAKE.
Kancare DD Watch invited both Brownback and Davis to attend the event. Brownback did not respond to the invitation, while Davis attended and gave short remarks saying that if elected, he would work to fix the problems in KanCare.