Archive for Tuesday, October 1, 2013

Hospitals complain of delays in new Medicaid system

October 1, 2013

Topeka — Hospitals are complaining about delays since the state switched to a new managed care plan for Medicaid.

When KanCare rolled out in January, most of the state’s Medicaid recipients were moved into plans administered by three private companies, the Topeka Capital-Journal reports. Since the switch, hospitals have reported problems getting reimbursed for services they perform and getting prior authorizations to provide certain types of treatment in a timely manner, said Cindy Samuelson, Kansas Hospital Association vice president for member services and public relations.

Hospitals estimate it is taking three to 10 days to authorize treatment, Samuelson said. She said the state has attempted to deal with the issues, but the insurers haven’t been as cooperative so far.

Lawrence Memorial Hospital, meanwhile, hasn't been running into similar issues. Staff did have to undergo required education about the additional tests that would require pre-authorization under the new system. “LMH is not experiencing any slowdowns in payment," said Stacy Cope, director of patient accounts. "As far as the LMH physician practices are concerned, they also have not seen any delay in payment or pre-authorization.”

The change to KanCare was promoted as a way to save money and improve care. Gov. Sam Brownback announced earlier this month that $37 million had been saved so far and said that would allow 650 more people with physical or developmental disabilities to get off the waiting list for in-home services.

But Carrie Saia, chief executive officer of Holton Community Hospital, said she was skeptical of the savings. She said some of the hospital’s staff members still were working on getting paid correctly for services performed in March, though rural health clinics affiliated with the hospital haven’t had the same difficulties.

“We expected there to be some bumps, but not 10 months into it, so many bumps,” she said. “The reason they’re saving so much money is we’re not getting paid correctly.”

— Journal-World reporter Giles Bruce contributed to this report

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