December 17, 2012 Legislative Update

December 17, 2010

Your Monday Morning Update:

I am so darn full that I think I’m going to burst!

Why?  Because I had to eat my words!

After all of the hearings, complaints, and feedback regarding KanCare, I said time and time again that there was no way that the Centers for Medicare and Medicaid Services (CMS) would give their blessing early enough to implement KanCare on the planned start date of January 1^st, 2013.  Boy oh boy was I ever wrong! On December 7^th, the Governor sent out a press release stating that the State had received CMS approval to begin KanCare on January 1^st.

The last mailing of KanCare assignments has gone out to Medicaid recipients.  If you are expecting a packet and have not yet received one, you might want to make a telephone call to find out where it is. “The dog ate it” won’t mean that it will go away.  You’ll be stuck with the Managed Care Organization (MCO) that you were assigned which may or may not be a good thing.  Because KanCare is now a “real thing”, be sure to do your homework when selecting one of the three MCO’s as you will have it for one year. 

Comments that I have heard:

• Not all my current doctors have signed up with the MCO’s.
• My doctor hasn’t been approached and doesn’t know anything about KanCare.
• We were supposed to be assigned the MCO which best met our needs, but none of my doctors or hospitals are on their provider list.  Is this a glimpse of “things to come?”
• The provider lists are extremely sparse and have very few specialists.
• Changing from one MCO to another is very confusing and time consuming.
• Very few hospitals have signed up to become providers. How far will I need to travel to access one on my list?
• It’s been very difficult to get information from the MCO websites.
• If I have to go to a doctor who isn’t on “the list”, the doctor will be paid less and may bill me for what isn’t paid.
• My child is their own guardian, however, requires my assistance.  What do I need to do in order to give, get, or change information with an MCO?

• There is no legislative oversight. Who will oversee this massive overhaul?

I have heard from many folks that they have had difficulty working through this complicated system. Regardless of that fact, it’s important to count our blessings.   Because folks on the long-term DD waiver are allowed to keep their case managers, you have help! Case managers are your closest allies, so I’d encourage you to work closely with them if you have questions. Don’t suffer in silence. In this case, silence is not golden…it’s frustrating!

Speaking of silence, you may not hear from me for a couple of weeks, so from my keyboard to yours, enjoy a joyous, happy, and healthy holiday season.

Lurena Mead

JCDS Community Relations Manager