KanCare payment issues make front page news

Gov. Sam Brownback announcing approval
to move forward with KanCare in 2012.
Courtesy of  Lawrence Journal World. 

Today's issue of the Topeka Capital Journal reported that the three private insurance companies administering KanCare have struggled to pay claims quickly.

An executive summary released by the Kansas Department of Health and Environment found that in 2013 none of the three managed care organizations, or MCOs, met the benchmarks for clearing clean claims within 20 days and all claims within 60.

"We are withholding part of the MCOs’ payments for failing to meet the requirement that they process 100 percent of clean claims within 20 days and 99 percent of all non-clean claims within 45 days," KDHE spokeswoman Sara Belfry said to the Topeka Capital Journal. "None of the MCOs met this pay-for-performance measure any month during the first year of implementation."

Concerns over claims processing delays spurred legislators to pass a "prompt payment" bill last session, in part to protect small home- and community-based providers who serve Kansans with developmental disabilities and rely almost solely on Medicaid.

The law imposes a 12 percent interest penalty on the three managed care organizations for late payments and provides a mechanism for the state to provide emergency payments to providers. It went into effect last month.

KanCare, an initiative spearheaded by Gov. Sam Brownback, is intended to save the state $1 billion over five years by placing the state's 350,000 Medicaid recipients under the administration of three private insurance companies paid a capped annual rate for service plus performance bonuses.

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