Kansas providers reluctantly accept Medicaid changes to fix billing woes

Kansas long-term care organizations say proposed changes to the Medicaid rebasing process aren't ideal, but are needed if it helps resolve issues stemming from the state's switch to privatized managed care.

The changes, which are currently under review by a legislative committee, would reduce the number of times per year the reimbursement rates for KanCare, the state's Medicaid program, are calculated. Currently the rates are rebased four times a year; under the proposed regulation it would drop to two.

The state's long-term care organizations, including LeadingAge Kansas and the Kansas Health Care Association, told the Kansas Health Institute News Service the changes weren't “a home run, great solution,” but many providers were willing to accept them for the chance that they'll solve billing issues that developed when private insurance companies took over the Medicaid program in 2013.

“The managed care companies have not been able to pay correctly basically ever since managed care started, because they cannot figure out how to do these quarterly adjustments,” Cindy Luxem, president and CEO of KHCA told KHI. “But I do have some members, quite honestly, that are not real pleased with it.”

Instead of reducing the number of a times a year the KanCare rates are recalculated, LeadingAge Kansas president and CEO Debra Zehr said a more ideal solution would be for the state to fix deficiencies with the quarterly rate changes.

“Instead of streamlining or correcting issues in the way and length of time it took to make those quarterly adjustments, their solution was to simply not do it as frequently,” Zehr said.