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

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Presentation transcript:

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

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 2

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 3

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 4

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 5

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 6

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 7

MCO Subcontractors AmerigroupSunflowerUnited Pharmacy Benefits Manager (PBM)CVS CaremarkUS ScriptOptumRX Behavioral Health Amerigroup will not use a behavioral health subcontractorCenpatico Optum Behavioral Health (also known as United Behavioral Health) Dental ServicesScion DentalDentaQuest Scion Dental Vision ServicesOccular BenefitsOpticare VSP Non-emergency Medical Transportation (NEMT)Access2Care Medical Transportation Management (MTM)Logisticare Kansas Medical Society Webinar 9/6/2012 8

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 9

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

For More Information HP Managed care unit helpline ( ) (New website!) Kansas Medical Society Webinar 9/6/

Questions? Kansas Medical Society Webinar 9/6/