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KHPA Home - Medicaid and HealthWave Comments to the Public Notice regarding the Medicaid Provider Payment Reduction have been received and copies are available upon request. Please contact Rita Haverkamp, Kansas Health Policy Authority, Landon State Office Building, 900 SW Jackson, Room 900-North, Topeka KS 66612-1220, or email at: Rita.Haverkamp@khpa.ks.gov. Copies of the comments will be made available directly to the requestor. KHPA Publishes Medicaid Rate Cuts - Public Notice
Click here to apply for assistance Featured Information KHPA Program Improvements:The Kansas Health Policy Authority maintains an ongoing process of reviewing elements of its programs and operations to identify opportunities for improvement, efficiencies and savings. The Program Improvements process began in 2008 with reviews of 14 major pieces of the Kansas Medicaid program. Those reviews led to the publication of the first Medicaid Transformation report in January 2009. That process is now being expanded to cover all programs and operations within KHPA, including the State Employee Health Benefits Program and KHPA internal operations. The overall purpose of the process is to produce and publish regular program reviews to monitor, assess, diagnose and address policy issues in each major program area within the agency. The presentation of these reviews is designed to serve as the basis for KHPA budget and policy initiatives on an ongoing basis. Working Healthy - Many people with disabilities want to work but worry that doing so could jeopardize their vital health and long term care coverage. Working Healthy offers people with disabilities who are working or interested in working the opportunity to get or keep Medicaid coverage while on the job. Through Working Healthy people can earn more, save more, achieve their career goals, and still maintain their health coverage. Announcements
Background on Medicaid and HealthWave The Medicaid and HealthWave division of KHPA is responsible for purchasing health services for children, pregnant women, people with disabilities, the aged, and the elderly through the Medicaid program, the State Children’s Health Insurance Program (SCHIP), and the state-funded MediKan program. On average, about 300,000 Kansas are enrolled in these programs each month. Medicaid is a federal-state program that provides health and long-term care services to people with low-incomes. All states currently participate in the Medicaid program and federal matching funds are available for the costs of these services. As a condition of state participation, each state must agree to cover certain populations and provide certain services (Fig. 1). KHPA is directly responsible for the purchase of health care services funded through the Medicaid program, while the Department on Aging and the Department of Social and Rehabilitation Services are responsible for administering long-term care services and mental health services. Nearly all health care services purchased by KHPA are financed through a combination of state and federal matching dollars either through Title XIX (Medicaid) or Title XXI (the State Children’s Health Insurance Program, or SCHIP) of the Social Security Act. Under Title XIX, the federal government provides approximately 60 percent of the cost of Medicaid services with no upper limit on what the federal government will reimburse the State. The State provides the remaining 40 percent of the cost of Medicaid services. As long as covered services are provided to eligible beneficiaries as specified in the State Medicaid Plan, the federal government must participate in sharing the costs of those services. Under Title XXI, the Federal government provides approximately 72 percent of the cost up to a maximum allotment, and the State provides the remaining 28 percent and any excess spent above the federal allotment. Health care services are purchased through both traditional fee-for-service and managed care models as described below. SCHIP provides health care coverage for low-income children living in families with incomes that exceed Medicaid limits. The federal government provides approximately 72 percent of the cost of SCHIP and the State contributes the remaining 28 percent, as well as any excess spent above the federal allotment. Unlike Medicaid, SCHIP is not open-ended; states are awarded yearly allotments. Kansas provides low-cost health insurance coverage to children who are under the age of 19, do not qualify for Medicaid, have family incomes under the 200 percent of the federal poverty level, and are not eligible for state employee health insurance and are not covered by private health insurance. Medicaid services are purchased through either a fee-for-service model or a managed care model. In the fee-for-service model, the State pays the provider directly. In the managed care model, the State pays a managed care organization (MCO) a monthly payment for each beneficiary. The MCO contracts with providers and pays them for services. SCHIP is provided only in a managed care model. Medicaid managed care and SCHIP are combined into one program, called HealthWave, designed to provide one seamless managed care option for families. The MediKan health program covers adults with disabilities who do not qualify for Medicaid, but are eligible for services under the State’s General Assistance program. MediKan provides limited benefits to adults whose applications for federal disability are being reviewed by the Social Security Administration. Health benefits include the provision of medical care in acute situations and during catastrophic illness. Overall, the scope of services covered by MediKan is similar to that covered by Medicaid, but a number of restrictions and limitations apply. Applicants for general assistance and MediKan are screened by KHPA staff for potential enrollment in Medicaid if they appear to meet federal requirements for disability. For more information about either Medicaid or SCHIP go to the Centers for Medicare and Medicaid Services website or the Kaiser Family Foundation website.
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