(Aug. 28, 2019) – This week, the Robert G. (Bob) Bethell Joint Committee on Home and Community-Based Services and KanCare Oversight met for two solid days. In addition to hearing testimony from providers, beneficiaries and organizations regarding the KanCare program, the Committee also received updates from the Kansas Department of Health and Environment, Kansas Department for Aging and Disability Services, and KanCare managed care organizations. One major topic of discussion during both days of the meeting was the lack of performance of the newest KanCare MCO, Aetna Better Health of Kansas. The concerns raised in the Kansas Hospital Association's testimony with contracting/credentialing and claims payment were echoed by other provider organizations, as well as KDHE. The Oversight Committee also grilled Aetna with concerns heard from their constituency. During their update to the committee, KDHE discussed their concerns with Aetna's response to the Corrective Action Plan placed on Aetna for non-compliance with the terms and conditions of their contract with the State. KDHE rejected Aetna's initial response to the CAP, indicating the plan submitted by Aetna did not adequately address the State's concerns nor did it present a clear path to compliance. KDHE received an updated CAP and is currently reviewing the revisions submitted by Aetna.
In their update to the committee, Randy Hyun, CEO of Aetna Medicaid, apologized to lawmakers for not living up to the expectations Aetna has for the Kansas market. During his testimony, Hyun said the company was taking steps to quickly improve its performance, including the removal of the management team that oversaw the KanCare contract and replacing them with Aetna experts from across the country to sort through the problems. In accepting responsibility for concerns with credentialing/contracting and claims payment, Aetna announced yesterday their plans to reinstate the continuity of care period through Oct. 31. In addition, Aetna has established an email box to allow providers an opportunity to escalate their concerns should they not receive timely or adequate response from their Aetna Provider Experience representative. This email box, firstname.lastname@example.org, will be monitored by dedicated Aetna staff.