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CMS Issues Notice to KDHE on Non-Compliance of KanCare

KanCare Last week, the Kansas Hospital Association received a copy of the Jan. 13 letter from the Centers for Medicare & Medicaid Services to the Kansas Department of Health and Environment outlining the problems they found in the KanCare program during their on-site visit in October 2016. The letter indicates the Kansas Medicaid program is substantively out of compliance with the requirements of the KanCare program, as authorized under Federal Medicaid statute and regulations, and places the health, welfare and safety of KanCare beneficiaries at risk.

Due to the "severe and pervasive nature" of the on-site review findings, CMS is requiring Kansas to develop a Corrective Action Plan describing actions it will take to correct the identified areas of noncompliance. KDHE must submit the CAP to CMS no later than Feb. 17, 2017. In the event that Kansas fails to submit the required CAP that is sufficient to mitigate the issues identified or to implement and monitor the CAP as approved by CMS, the agency indicated they will initiate formal compliance actions, including financial sanctions of state administrative funds. KDHE also received a letter from CMS, dated Jan. 17, indicating that the state's request for an extension to the current KanCare 1115 Waiver would not be granted at this time. Kansas' execution of the CAP and measured performance improvement will ultimately impact CMS' approval of the one-year extension of the KanCare program in the future.

While these letters validate a number of the concerns that KHA and other provider associations, beneficiaries and patient advocates have raised over the past four years, it is vital that Kansas hospitals maintain their efforts to work closely with KDHE. It is essential that the patients served by KanCare continue to receive quality health care, and hospitals receive reimbursement for providing that care.