MCO Implementation

KanCare 3.0 launched Jan. 1, 2025, with Healthy Blue joining UnitedHealthcare and Sunflower as KanCare MCOs. Since then, KDHE has met with Healthy Blue frequently to ensure a smooth transition and address any issues quickly. To present, no systemic issues have been identified and individual issues have been promptly resolved. Kansas Medicaid exited the implementation phase at the end of February and is returning to typical business operations one month ahead of schedule. KDHE thanks the MCOs, our partners and State staff for their hard work and focus on launching KanCare 3.0 successfully.

Aetna has been an excellent partner as they exit the Kansas Medicaid program. They have been cooperative and willing to address concerns, leading to a successful transition with Healthy Blue as well as ensuring claims payment to providers for services rendered during the term of their contract.

Rate Study

The Kansas Medicaid rate study has begun being posted on the KanCare website. The study compares Kansas Medicaid rates to rates in Nebraska, Missouri, Iowa, and Colorado, and to Medicare rates when available. Currently, dental, evaluation and management and radiology reports are publicly posted, with additional reports to come.

EPSDT

KDHE continues to work on improving the EPSDT program in Kansas. Currently, there is a small workgroup of state staff and stakeholders reviewing family and public facing EPSDT information to improve how we are communicating with EPSDT is and what families’ rights are under the program. After the workgroup finishes their work the revised communication tools will be shared with a larger group of stakeholders and families. At the same time, KDHE is working with the MCOs on complying with federal requirements for the program and how to educate providers on the EPSDT program. This work will also include how KDHE will monitor the MCOs to ensure compliance. More information will be available in coming months.

School-Based Services Grant

KDHE was award a $2.5 million grant to enhance school-based services in the summer of 2024. The grant will facilitate several key initiatives:

• Enrollment assistance to help eligible students and their families access Medicaid coverage.
• Provision of a broad array of Medicaid-covered health services directly within schools.
• Enhanced outreach and educational efforts to promote the health and wellness of students, reducing the need for emergency care and boosting educational outcomes.

Transforming Maternal Health (TMaH) Model Grant

Kansas has been selected by the Centers for Medicare and Medicaid Services (CMS) as one of 15 states to participate in its Transforming Maternal Health (TMaH) Model program, which includes a $17 million grant award over the next 10 years. The TMaH selection will enhance the work the Kansas Department of Health and Environment (KDHE) has initiated through its Kansas Medicaid and Maternal and Child Health programs to improve maternal health outcomes for members.

The grant will allow KDHE to build upon its work in the following: 

• Hospital Engagement for Birthing-Friendly Designation: KDHE, in collaboration with the Kansas Perinatal Quality Collaborative, the Kansas Maternal Mortality Review Committee, and other partners, is recruiting and educating facilities to achieve CMS’s birthing-friendly designation status. TMaH will align with these key public health initiatives to further address barriers and increase quality services and patient safety. 

• Whole-Person Care: KDHE’s Kansas Connecting Communities and Maternal Anti-Violence Innovation and Sharing programs will be pivotal in enhancing the patient education and universal screening components of the TMaH model. These programs offer provider consultation, training, and technical assistance for perinatal mental health, substance use, and intimate partner violence. Resources will be scaled to ensure the behavioral health and social determinants of the health needs of all patients. 

• Telehealth and Telemonitoring Prioritization: TMaH will enhance telehealth services to overcome geographic barriers, improving access to specialists and reducing travel. KDHE will implement robust telemonitoring for hypertension and gestational diabetes and collaborate on a State Plan Amendment to expand covered services under Medicaid. 

• Home Visiting Program Expansion: The TMaH payment model will make home visiting sustainable by addressing funding gaps. KDHE’s strength-based approach improves outcomes in pregnancy, parenting, and early childhood health while TMaH funding expands reach and quality. 

Legislative Activities

The Kansas House and Senate have both passed out their state fiscal year 2026 budgets. Both budgets contain several rate increases and some new services for the Medicaid program.  There are differences between the budgets that House and Senate will negotiate and then the Governor can line-item veto items once the agreed-upon budget is passed. It will be several weeks before KDHE can report on the final budget.

KDHE is monitoring bills that would restrict Medicaid’s ability to respond quickly to emergencies or CMS mandates as legislative review and approval would be necessary.

While there is lots of news regarding Medicaid cuts at the federal level, currently there are no formal proposals that have been developed.  KDHE is monitoring closely and will respond as soon as information on what cuts are being proposed is known.

• EVV Town Hall 23: New Features; April 16, 2025, noon to 1 p.m.