Recipients can switch KanCare plan [Topeka Capital Journal (KS)]

Almost one year into the KanCare managed care Medicaid reforms, Kansans enrolled in the public health reforms soon will have their first opportunity to assess the service the three managed care companies have provided and decide whether to switch to another plan.

Informational packets are being mailed to KanCare members, with the open enrollment period for 2014 health coverage set to begin Dec. 1.

Miranda Steele, a spokeswoman for the Kansas Department of Health and Environment, said members will be able to contact KDHE to change their plan for 90 days after that date.

"When a member calls to make changes, the changes take effect the first day of the next month," Steele said. "If they're good with their current plan, they'll be automatically re-enrolled in the same plan -- no need to take action."

KanCare members were auto-enrolled last year, with a similar time window to switch, in one of three managed care companies with whom the state contracts. The companies -- Sunflower State Health Plan (a division of Centene), Amerigroup and United Health Care -- all offer slightly different benefits, with more information available at http://www.kancare.ks.gov/choosing_a_plan.htm.

Rocky Nichols, executive director of the Disability Rights Center of Kansas, said the companies also have different provider networks, so KanCare members would be well-served to contact their medical providers and find out if there is one company that has more of them in network.

"Look very closely at the different plans and compare, not just whether your doctor is participating, your primary care physician, but your specialists," Nichols said. "Particularly for people with disabilities, they may have multiple specialists. That cross- referencing takes a lot of time, and it can be difficult."

Nichols said his staff would be willing to provide advice to KanCare members with disabilities, but they wouldn't endorse one plan over another, and examining the plans isn't the center's primary function.

"We can provide consultation with people with disabilities," Nichols said. "It's going to be limited as far as advising them what MCO (managed care organization) to choose."

Nichols said those on Medicaid waivers have an extra layer of research to do in finding out which managed care companies their case managers are working with. The trick, he said, is they have to triangulate that with their medical providers.

"If they only go to the MCO where their case manager is, that doesn't mean that MCO contracts with their doctor or their specialists," Nichols said.

Nichols encouraged KanCare members with disabilities to talk not only to their medical providers and their case managers, but also to other people with disabilities and ask them about their experiences with the different companies. If it becomes clear that one MCO is better at providing disability services, he said members should "vote with their feet" and switch.

"This open enrollment is really important," Nichols said. "It's the new reality, right or wrong, so people have to be very careful and just do their homework."