(Aug.13, 2026) – The Robert G. (Bob) Bethell Joint Committee on Home and Community-Based Services and KanCare Oversight met on Aug. 11-12 to discuss KanCare, Medicaid waiver programs, behavioral health services and other issues affecting providers and patients.

The committee began by hearing from individuals, providers and organizations about their experiences with KanCare and the state's Home and Community-Based Services programs. Much of the discussion focused on waiver waitlists, reimbursement rates, workforce challenges and concerns about managed care organizations. Providers raised concerns about lengthy credentialing processes, prior authorization and delayed payments, including testimony that hundreds of previously authorized claims had been withheld for months. Committee members questioned whether existing KanCare contract requirements are adequately enforced.

The committee also spent significant time discussing the state's HCBS waiver waitlists. Kansas Department for Aging and Disability Services officials reported the Physical Disability waiver waitlist has recently been cleared, while the Frail Elderly waiver now has a waitlist. The new Community Support waiver for individuals with intellectual and developmental disabilities is scheduled to begin on Oct. 1. KDADS identified several potential legislative considerations, including:

• Increased funding to expand waiver capacity;
• Investments in wages and training for direct support professionals;
• Improving rural access and provider capacity;
• Streamlining processes within KanCare; and
• Ongoing efforts to identify fraud, waste and abuse.

Committee members expressed significant frustration with the time it takes to move individuals from waitlists into services and questioned why approximately $24 million in prior-year IDD waiver funding had not been used to add additional waiver slots. Members also raised concerns about whether individuals who accept services through the new Community Support waiver could lose their positions on the IDD waiver waitlist.

Behavioral health and certified community behavioral health clinics were another major focus throughout the two-day meeting. KDADS reported the first round of calendar year 2025 CCBHC metrics is expected this year, with the state's CCBHC Sustainability Advisory Group beginning its work later this summer. The committee heard that Kansas' CCBHCs responded to 8,838 mobile crisis requests in fiscal year 2026, and 6,600 individuals who received mobile crisis services were diverted from higher levels of care. New clients seeking CCBHC services have generally received initial evaluations and clinical services within the federal 10-day access expectation. However, committee members also questioned whether the state has sufficient data to evaluate outcomes given the significant investment in CCBHCs.

MCO presentations on the second day raised concerns about rising costs and utilization patterns, while other testimony highlighted improved access and crisis response. Committee members requested additional outcome data and noted CCBHC performance and reimbursement will remain under review.

Kansas Medicaid Inspector General Steven Anderson provided updates on several ongoing audits. The inspector general has begun an audit of CCBHCs to examine billing, services provided and oversight of the prospective payment model. The office is also reviewing whether eliminating prior authorization for complex wheelchairs increased costs or improved access. Preliminary findings from a separate audit of pharmacy dispensing fees showed approximately $8 million was spent on dispensing fees for over-the-counter medications, with dispensing fees accounting for 53 percent of those costs.

The long-term care ombudsman also raised concerns about involuntary discharges from long-term care facilities. The ombudsman described instances in which residents are transported to hospitals for emergency treatment but are not subsequently readmitted by the facility. Hospitals are encouraged to report these situations to the ombudsman's office when they occur (see more information on page 10 of the ombudsman's testimony). The committee also discussed concerns about fees charged to residents who choose pharmacies other than the facility's preferred pharmacy.

Kansas Department of Health and Environment officials provided an update on implementation of the Rural Health Transformation Program. The REH/CAP and Rural Partnership Grant Program awards, totaling $30 million and $50 million respectively, were awarded in May. More than 60 hospitals have signed up to participate in the Evidence-Based Practices Program, and a $16 million Emerging Technology program is forthcoming.

KDHE indicated additional year-two funding opportunities will be released in the coming months. State Medicaid Director Christine Osterlund also discussed federal Medicaid changes, provider revalidation and ongoing program integrity efforts. KDHE reported it is beginning to more closely use contractual enforcement mechanisms with KanCare MCOs. When asked whether the state has previously assessed liquidated damages against an MCO, Osterlund said it had not done so since KanCare began in 2013. KDHE is now issuing noncompliance letters and will begin receiving reports on MCO compliance with service-level agreements that could result in liquidated damages.

KDADS concluded the meeting with updates on the state's HCBS programs, workforce and state hospitals. The agency reported the Community Support waiver was approved July 1 and will begin Oct. 1. KDADS also continues work to modernize IDD services, including standardized functional assessments, service definitions and future rate modernization. Recommendations from the state's direct support workforce efforts include increasing wages and access to benefits, conducting a comprehensive HCBS rate study and expanding partnerships with education systems to strengthen workforce pipelines.

The committee will meet again Oct. 6 and 7.