(Oct. 8, 2026) – Bethell Committee Advances Medicaid and KanCare Recommendations
The Robert G. (Bob) Bethell Joint Committee on Home and Community-Based Services and KanCare Oversight met Oct. 6-7 for its final interim meeting to discuss KanCare, Medicaid waiver programs, behavioral health services and other issues affecting providers and patients.
KanCare managed care organizations faced significant questioning from committee members about prior authorization, credentialing and claims payment. Of particular concern was whether managed care organizations are denying payment for services after a prior authorization has already been issued. The MCOs generally said they would need to provide the committee with additional information. Sen. Stephen Owens, R-Hesston, expressed concern that providers still struggle to resolve these issues when working directly with MCO staff. The committee ultimately voted to recommend KDHE provide a report on instances in which MCOs refuse payment after issuing prior authorization.
UnitedHealthcare highlighted changes to reduce the prior authorization burden. Its Gold Card Program exempts certain high-performing providers from prior authorization requirements, and 11 Kansas providers currently qualify. A new Rural Health Gold Card Program will remove the program's minimum prior authorization volume requirement for qualifying rural providers. UnitedHealthcare reported that 99 Kansas providers currently qualify for the rural program, which is scheduled to launch Nov. 1.
The committee received an update on the federal Office of Inspector General audit, which found Kansas was not adequately ensuring parity between behavioral health and medical/surgical services under KanCare. The Kansas Department of Health and Environment reported the state came into compliance with federal mental health parity requirements in June. Going forward, KDHE and the Kansas Department for Aging and Disability Services will conduct random audits of denied behavioral health claims, in addition to the annual Mental Health Parity and Addiction Equity Act review process.
Certified Community Behavioral Health Clinics and MCOs discussed the ongoing development of scorecards to measure CCBHC performance and utilization. CCBHC representatives raised concerns about how certain services are categorized and whether the proposed measures adequately capture community-based care. The committee recommended MCO scorecards include validated patient-level data, clear and timely requirements and appropriate context when measures relate to services that will no longer be reimbursable beginning Jan. 1, 2027.
At the request of the Legislative Coordinating Council, the committee reviewed four Medicaid policy changes. The committee recommended approval of funding for speech-generating device evaluation and training, expanded hereditary breast cancer screening and interprofessional consultations. A proposal to extend a recent pediatric office-visit rate increase to additional provider types was not recommended. The proposals now return to the LCC for final consideration.
Other recommendations approved by the committee for consideration during the 2027 legislative session include:
- Providing funding to reduce the Intellectual/Developmental Disability waiver waitlist to 4,000 by FY 2028 and funding sufficient to eliminate the Frail Elderly waiver waitlist.
- Moving toward greater rate parity for self-directed home and community-based services and evaluating the fiscal impact of doing so over multiple years.
- Using a single functional assessment rather than separate assessments from KDADS and KanCare MCOs.
- Reviewing the assessment process for the Technology-Assisted waiver.
- Requiring nursing facilities to provide certain information, including residents' rights and power-of-attorney information, to residents and their surrogate decision-makers.
- Asking the Insurance Committee to consider pharmacy provider-of-choice legislation.
- Evaluating an increase to the current 25-hour limit for HCBS day services.
The committee will next meet in 2027.