Category Archives: News

Threats to Case Management Services

The Arc of Sedgwick County says …

There are several issues that are facing Targeted Case Management (TCM) Services in Kansas for our families receiving Intellectual and Developmental Disability (I/DD) services. When the state shared that they have heard our families and have assured them that they can keep their case manager, they didn’t share that they would cut the rate of Targeted Case Management to a level that will make it almost impossible for agencies to continue to provide the services. Continue reading

Sunflower Will Cap Case Management Services

Below is official communication from Sunflower Health sent on September 9 to service providers.

“Sunflower Health Plan has received requests from Targeted Case Management providers for units above the TCM benefit limit. Sunflower intends to enforce the state-established limit of 240 units per year but will review exception requests for consumers with the most complex needs. Sunflower will note denial reasons in the TCM PA system.  Continue reading

Switch to KanCare complicates Medicaid fraud detection

Advocate says …

Attorney general’s report echoes challenges in other states with managed care organizations

Switch to KanCare complicates Medicaid fraud detection

By Andy Marso KHI News Service Aug. 29, 2014

TOPEKA — The state’s privatization of Medicaid is complicating efforts to detect fraud and abuse, according to a recently released report from Kansas Attorney General Derek Schmidt’s office. Continue reading

None of Kansas’s KanCare Providers Hit Benchmarks

Wichita Eagle, August 13, by Bryan Lowry, Eagle Topeka Bureau

None of the state’s KanCare providers hit the state’s benchmark for timeliness in claims processing during any month in 2013, according to an August report from the Kansas Department of Health of Environment.

The state set a goal to have 100 percent of clean claims processed in 20 days and 100 percent of all claims processed in 60 days. The state’s three KanCare providers — Amerigroup, Sunflower Health and United Healthcare — failed to meet that benchmark for all 12 months of 2013, according to the KanCare executive summary released this month. Continue reading