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KMS provides comments regarding KanCare contracts

KMS recently met with the Kansas Department of Health and Environment (KDHE) to share recommendations for the next round of KanCare contracts. As the state moves forward with developing and awarding these new contracts a few of the recommendations KMS shared for consideration are listed below:

  • Resolution of ongoing payment issues
  • Enforcement of state policies and manuals
  • Reduction of administrative burden
    • Prior authorizations – simplify and standardize prior authorization requirements across contracted MCOs and lifting the requirement for those that prove not to be an outlier
    • Engage provider associations in the development of quality-based performance measures to ensure appropriateness and consistency of measures
  • Limit MCO recoupment timeline to mirror state expectations of 2 years
  • Ensure sufficient time for any new KanCare MCO to be ready for January 1, 2019 start date

The renewal of KanCare is designed to continue the program for an additional five years, 2019-2023. KDHE expects to release the Request for Proposal (RFP) in November and announce the awards in June of 2018. It is likely that the three current Managed Care Organizations (MCOs)–Amerigroup, Sunflower Health Plan, and UnitedHealthcare Community–will bid. Other payers that have expressed an interest include, Aetna, AmeriHealth Caritas, Molina Healthcare and Wellcare.

If you have questions or concerns about KanCare or to learn more about this process contact Ruth Cornwall, KMS Director of Health Care Finance by email at This email address is being protected from spambots. You need JavaScript enabled to view it. or by phone at 785.235.2383.

 

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