Kansas Submits Medicaid Waiver Application

TOPEKA, Kan. (WIBW) - Kansas has officially applied for permission to overhaul its Medicaid program.

Gov. Sam Brownback and Lt. Gov. Jeff Colyer said the state turned in its application Thursday to the Centers for Medicare and Medicaid Services. The 50-page documents outlines Kansas' proposal for turning the state's program providing health care to the poor, disabled and elderly to three companies. Dubbed "KanCare," it would launch in 2013.

The state turned in initial paperwork in January.

“We sincerely appreciate the accessibility and candidness of CMS throughout this application process. This revised version of our earlier waiver request demonstrates the commitment by the state and the federal government to improve the health outcomes of Kansans and sustain the healthcare coverage afforded by our Medicaid program,” Colyer said.

The state turned in its application a day before new rules took effect. Among other things, the new rules require public hearings on proposed changes before a state can submit its request to the federal government.

Brownback said the timing was coincidence.

The Associated Press contributed to this report.

News release from the Governor's office:
The State of Kansas this week updated its Section 1115 demonstration waiver application to the Centers for Medicare and Medicaid Services (CMS), placing the state-federal partners in a position to complete the first of two tracks in the ongoing collaboration to reform Kansas’ Medicaid system. This 50-page document provides CMS with additional information on the proposal outlined in the state’s application paper submitted in January.

“We sincerely appreciate the accessibility and candidness of CMS throughout this application process. This revised version of our earlier waiver request demonstrates the commitment by the state and the federal government to improve the health outcomes of Kansans and sustain the healthcare coverage afforded by our Medicaid program,” said Lt. Governor Jeff Colyer, M.D.

The State has requested a two-track waiver approach. This first waiver application asks CMS to support implementation of the State's integrated system of care, KanCare, by 2013. In the second, separate track, the State seeks to begin discussions with CMS to implement a future global waiver to maximize flexibility in administering an outcomes-based program.

The current system for Kansas’ Medicaid program does not include measureable health outcomes as a financial incentive feature, nor does it have the capacity to adequately support anticipated growth in program enrollment because of an aging population. In the spring of 2011, the State began the application process by first issuing a RFP requesting suggestion on Medicaid reforms. Next, the state facilitated a series of Medicaid public forums during which more than 1,800 participants engaged in discussions on how to reform the Kansas Medicaid program. Forum participants produced more than 1,500 comments, while a web-based tool received an additional 500 comments on recommendations for reform. The Administration announced the KanCare reform plan and request for proposal in November 2011. The input gained from that formal, year-long public process is contained in the application submitted in January and updated this week.

Waiver authority is being sought to move all Medicaid populations into a person-centered integrated care system by 2013, with the long-term services and supports for the intellectually and developmentally disabled consumers beginning in the new system in 2014. The goal is to avoid cutting Kansans off of Medicaid or reducing provider rates which would harm patient care. KanCare will provide integrated care that supports improved, long-term outcomes for the neediest Kansans. Kansas also is creating an off-ramp from dependence on government programs to independence by increasing opportunities for work, particularly among disabled Kansans, and helping to expand opportunities for private insurance.

Generally, 1115 waivers are approved for a five-year period. The federal government has forced Kansas to increase state spending on Medicaid by hundreds of millions of dollars annually. It is projected the federal government will cut several hundreds of million dollars from Kansas Medicaid in the next several years. Based on a conservative baseline, KanCare is expected to achieve savings of $838 million (all funds) during the next five years.

The first-track waiver request documents—the January 26th application paper and today’s update —are available online at www.kdheks.gov/hcf/kancare/.

The Kansas Department of Health and Environment (KDHE) is accepting public comments on the application. Comments can be submitted electronically by emailing KanCare@kdheks.gov.


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