Kansas Senate health committee adopts rules; hears report recommending steps to separate Medicaid case management

The Kansas Senate Committee on Public Health and Welfare adopted its rules for the year by voice vote and heard a presentation of recommendations from the Special Committee on Targeted Case Management, which urged a statewide survey of waiver participants, a KDADS response to Centers for Medicare & Medicaid Services guidance, and legislative review of provider capacity and reimbursement.

Dayton Lamonyan, senior fiscal analyst with the Kansas Legislative Research Department and facilitator for the special committee, told members that “targeted case management is a Medicaid state plan service that helps coordinate services for individuals with intellectual developmental disabilities.” He said much of the committee’s recommendations “revolve around a plan to separate the case management services from the actual provision of services,” and that KDADS reported it had received instruction from CMS that those functions should be separated.

The special committee recommended that the Kansas Department for Aging and Disability Services distribute a survey to waiver participants, people on the waitlist and other stakeholders, and report findings to lawmakers by Dec. 15, 2024. The report also recommended that KDADS develop a Kansas-specific response to CMS requirements to prevent conflicts of interest in targeted case management (TCM), including maintaining agency-based and independent case managers where allowed, creating a clear firewall for agency-based providers, building a monitoring system and allowing rural-area exemptions. The special committee also recommended that the House and Senate health standing committees review TCM provider capacity and reimbursement rates during the 2025 session.

Lamonyan summarized public testimony to the special committee, saying members received comments from individuals and families and separate testimony from providers and stakeholders. He said providers generally expressed a preference for keeping the current system in place. In response to questions from senators, Lamonyan said the special committee had not received written documentation from CMS at the time of its meeting and that the committee had approved drafting a letter to CMS asking for written documentation of the conflict-of-interest provisions and whether CMS was aware of existing Kansas rules.

Senator Chase Blasey asked whether KDADS had distributed the recommended survey to waiver participants; Lamonyan replied, “I have not received any information as to about the survey being distributed or results.” Committee staff and members indicated a KDADS presentation and supplemental materials were expected at a later meeting during the week. Senator Clifford pressed on provider concerns about business models and conflicts of interest; Lamonyan said providers had testified they preferred the system remain in place but that the committee lacked written CMS guidance at the time.

Procedural action taken during the meeting included adoption of the committee’s rules for the year. The transcript records a voice vote with members saying “Aye” and the chair announcing, “The rules have been adopted.”

Dayton Lamonyan departed after questions and the committee was reminded it would reconvene for a full meeting later that week.

Votes at a glance

- Committee rules for the year: adopted by voice vote; transcript records “Aye” and the chair’s announcement that the rules were adopted. No roll-call tally recorded in the transcript.

(Reporting note: dates and follow-ups — for example, Dec. 15, 2024 for the survey report — appear in the special committee’s written recommendations as read into the record.)