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KanCare Implementation Update

KanCare Implementation Update. Becky Ross Medicaid Initiatives Coordinator KDHE/Division of Health Care Finance. KanCare Basics: What is Covered?. All Medicaid services covered now Physical health care, including pharmacy, dental, vision, NEMT

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KanCare Implementation Update

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  1. KanCare ImplementationUpdate Becky Ross Medicaid Initiatives Coordinator KDHE/Division of Health Care Finance Kansas Medical Society Webinar 9/6/2012

  2. KanCare Basics:What is Covered? • All Medicaid services covered now • Physical health care, including pharmacy, dental, vision, NEMT • Behavioral health care, including treatment for mental illness and substance use disorders • Long term supports and services, including nursing facilities, ICFs/MR, and HCBS waiver services • DD waiver services and targeted case management will be delayed one year Kansas Medical Society Webinar 9/6/2012

  3. KanCare Basics: Who is Covered? • All Medicaid and CHIP beneficiaries • Excluded populations include: • SOBRA • MediKan • PACE • Native Americans will have the option to be in KanCare • LEA and ECI carved out Kansas Medical Society Webinar 9/6/2012

  4. KanCare Basics:What Stays the Same? • Eligibility requirements • Current services • Current rates • Medicaid ID numbers • Eligibility review dates • KAN Be Healthy benefits Kansas Medical Society Webinar 9/6/2012

  5. Implementation Progress • Process • Internal implementation teams • External workgroups • Weekly meetings with MCOs • Consultants helping with readiness reviews and work plan • Contracts • Templates being reviewed and approved by contracts, program and legal staff Kansas Medical Society Webinar 9/6/2012

  6. Contract Approvals • Amerigroup • Physician and Allied Health • Ancillary Services • Facilities • Hybrid (PAH and Facility) • Hybrid (PAH and Ancillary) • Nursing • FQHC/RHC • HCBS Kansas Medical Society Webinar 9/6/2012

  7. Contract Approvals • Sunflower • Physician • Hospital • Nursing • HCBS • United Healthcare • Small Medical Group and Medical Group • Pharmacy • FQHC/RHC • Hospital Local and National • Nursing • HCBS Kansas Medical Society Webinar 9/6/2012

  8. MCO Subcontractors Kansas Medical Society Webinar 9/6/2012

  9. Readiness Reviews • Network adequacy reports due monthly from MCOs • Onsite readiness reviews beginning this week • Each will be preceded by a desk review • Teams of KHDE and KDADS staff will perform onsite reviews • Review IT, financial, administrative and clinical systems Kansas Medical Society Webinar 9/6/2012

  10. Education • First tour (July 30 – August 2) • About 200 of over 1,000 Q&As posted (http://www.kancare.ks.gov) New website! • Lessons learned • Second tour (September 24 – 27) • Four teams, twelve cities • Teleconference on the 27th Kansas Medical Society Webinar 9/6/2012

  11. For More Information • HP Managed care unit helpline (1-866-305-5147) • http://www.kancare.ks.gov (New website!) Kansas Medical Society Webinar 9/6/2012

  12. Questions? Kansas Medical Society Webinar 9/6/2012

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