The state of Kansas has submitted an application to extend its KanCare Section 1115 Demonstration for an additional year with no changes. As the notice put out by CMS notes, KanCare provides statewide managed care to the majority of Medicaid state plan populations for physical, behavioral, and long term care services, operating concurrently with the state’s section 1915(c) Home and Community-Based Services (HCBS) waivers. Together, they provide the authority necessary to require enrollment of almost all Medicaid beneficiaries (including the aged, disabled, and some dual eligibles) into a managed care delivery system to receive state plan and HCBS waiver services. KanCare also includes a safety net care pool to support certain hospitals that incur uncompensated care costs for Medicaid beneficiaries and the uninsured, and to provide incentives to hospitals for programs to enhance access to health care and improve the quality of care.
Kansas, like other states, has struggled with the roll out of Medicaid managed care plans that include people with disabilities. It has been challenging for states and managed care organizations to accurately predict costs associated with the provision of services which lie outside of MCOs' traditional experience, which can lead to higher than expected costs, gaps in service, or both. The demonstration at issue was approved initially in 2012, but added the provision of I/DD services in 2014. (See WICs article, "CMS Approves Kansas' Inclusion of I/DD Waiver Services in Managed Care Demonstration," January 31, 2014.) The federal public comment period on the proposed extension will be open from August 11, 2017 to September 10, 2017. Public comments already submitted are available here.