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Mercy now a KanCare provider

Friday, January 11, 2013

Now that KanCare -- the state's new Medicaid program -- is in force, Mercy Hospital wants beneficiaries to know they can still come to the Fort Scott facility for care.

Jan. 1, the KanCare program went into effect. The state had to get a waiver from the Centers for Medicare and Medicaid Services, but did not receive its approval letter until Dec. 27, 2012. This gave Kansas virtually no time to get the information out, said Karen Endicott-Coyan, regional reimbursement director and advocacy coordinator for Mercy.

Under the new program, Kansas contracted with Amerigroup, Sunflower State Health Plan and United Healthcare to provide managed care for Medicaid beneficiaries. All Mercy physicians and locations are in-network for KanCare Medicaid program, even if they're not listed in the provider directory, Mercy's website said.

An average of about 300,000 Kansans are enrolled in Medicaid each month, Endicott-Coyan said. Eligibility is based on income, so clients may come and go from the rolls. KanCare does not include developmentally disabled people at this time.

"A Medicaid beneficiary can keep the same doctor they had before; they can receive the same in home health services they received before; and they can see the same specialist," Endicott-Coyan said. "It's just that providers -- doctors, hospitals, pharmacies, optometrists, dentists -- everyone who provided services to Medicaid beneficiaries all had option to sign a contract with these three managed care organizations. But because of the timing, and this was a statewide thing, some of the information is not updated yet on those MCO's websites."

There is a 90-day grace period where even if a physician has not signed a contract, they will still be paid at the same rate they were prior to Jan. 1.

"The intent of the program was not to make anyone change doctors, hospitals, pharmacists or anything like that," Endicott-Coyan said. "The intent of the program was to manage the care of the Medicaid beneficiaries and to curb the cost for the state of Kansas."

One difference under KanCare from the state's previous Medicaid program is that beneficiaries will have case managers, so if someone has several medical issues, the managed care organizations will have case managers who will coordinate their care.

Amerigroup, Sunflower and United Healthcare all have new services available to patients, such as providing a cell phone to remind them of appointments.

For more information, visit Kancare.ks.gov and click on frequently asked questions.

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