Kansas tells Medicaid contractor to improve current plan

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TOPEKA, Kan. (KSNT) – Aetna, an insurance company contracted with KanCare, the state’s Medicaid system, is under fire after the state said it delayed payments to healthcare providers across Kansas.

Due to this delay, some doctors in hospitals, home health and clinics are not getting paid for services until months after they were originally provided.

Aetna began a contract with the state of Kansas at the beginning of 2019, replacing Amerigroup to join United Healthcare and Sunflower as Medicaid providers.

“We anticipated there’d be a learning curve, but it’s been long enough in the program that we feel like they need to improve on the processes that they have in place in Kansas,” said Cindy Samuelson, vice president of the Kansas Hospital Association. “Maybe build on their team, bring in some more experts to help us be able to process claims more quickly and do the right credentialing in our state.”

Aetna specifically provides Medicaid coverage to about 100,000 Kansans, each of which could see a stop to their care if this delay continues.

“In the long run you could think now hospitals are going to take care of patients no matter what. But some providers may say ‘oh this is not a required procedure, this is an Aetna patient and I’m not getting paid because there’s been challenges,’” Samuelson said. “That could eventually down the road lead to a gap in access to care for those patients.”

KSNT News contacted Aetna by phone and email and did not immediately receive a response.

Stormont Vail Health in Topeka is continuing to work with Aetna to ensure that their claims are being processed accurately, according to spokesperson Matt Lara.

“Stormont Vail remains committed to providing high-quality, compassionate care to all patients, regardless of a patient’s ability to pay or who their insurance carrier is,” Lara said.

The Kansas Department of Health and Environment has asked Aetna to correct the issue.

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