KanCare companies lack specialists in Topeka area

December 27, 2012, 12:00 pm

TOPEKA, Kan. (AP) — The three managed care companies that will take over Kansas Medicaid services have strong primary care physician networks but some gaps in their specialty provider networks in the Topeka area, according to recent data.

Sunflower State Health Plan had no providers within 25 miles of Shawnee County in nine of 22 medical specialties, including allergy, dermatology and orthopedics, the Topeka Capital-Journal reported Thursday (http://bit.ly/WVjd6Z) based on data collected earlier this month. Shawnee County, which includes Topeka and the surrounding area, is the third most populous county in the state.

A second company, Amerigroup, didn't have any providers in nephrology, physical medicine/rehabilitation and plastics and reconstructive surgery within 25 miles of Shawnee County, and United Healthcare had no neonatologists within 25 miles of Shawnee County.

The three companies have been building provider networks since this summer, when they were announced as the recipients of contracts for KanCare, Gov. Sam Brownback's managed care plan for Medicaid. Most of the state's 380,000-some Medicaid recipients have been assigned to one of the companies, but starting Jan. 1, they will have 90 days to switch between them.

United Healthcare spokeswoman Alice Ferreira said the networks are constantly changing and the company responds to member needs.

"No one's in any immediate or eminent danger of having no access to their doctor," Ferreira said.

Brownback and other members of the administration say KanCare is imperative to stem burgeoning Medicaid costs. They estimate it will save the state more than $1 billion during the next five years without cutting benefits, limiting enrollment or lowering provider compensation rates.

Miranda Steele, spokeswoman for the Kansas Department of Health and Environment, said provider networks have grown since the document was last updated and will continue to grow after KanCare goes live. She also said it's up to the managed care organizations to ensure specialist care.

"The MCOs must guarantee access to specialists, so if a specialty is not available in their network in a specific area, they must make arrangements for members to access those services out of network," Steele said.


Information from: The Topeka (Kan.) Capital-Journal,

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