WASHINGTON – Former sex crimes prosecutor and U.S. Senator Claire McCaskill today applauded the policy recommendations of the White House Task Force on Protecting Students from Sexual Assault, a new initiative from the White House Council on Women and Girls to help make college campuses safer for America’s students.

“Everybody needs to be all-in on this fight, and the White House has shown great leadership in putting this together.” said McCaskill, who helped lead the recent successful effort dramatically reforming the military justice system. “These recommendations are strong-they will be a critical part of our efforts moving forward, and I look forward to working closely with the White House on legislation to better protect our students and ensure perpetrators aren’t getting a free pass. Because no young person suffering the results of a crime as personal and traumatic as sexual assault should feel like they’re on their own.”

McCaskill-who will attend today’s White House ceremony announcing the recommendations-recently launched a massive survey, the first congressional inquiry of its kind, of colleges and universities to learn exactly how schools handle rapes and sexual assaults on campuses-specifically focusing on how such crimes are reported and investigated and how students are notified about available services. The survey will gauge the effectiveness of federal oversight and enforcement under Title IX federal civil rights law and the Crime Awareness and Campus Security Act, commonly known as the Clery Act. McCaskill is surveying colleges and universities nationwide that represent different types of institution (public, private non-profit, and private for-profit) and vary in size.

The White House Task Force has established Notalone.gov, which will provide resources to students including access to a list of their rights, how to file a complaint, learn about enforcement data, and find mental-health services in their area. The Task Force’s recommendations (available online HERE) also include urging colleges to conduct anonymous campus climate surveys to learn more about sexual assault cases on their campuses, offer sexual assault training for school administrators, and help schools respond effectively when a student reports an assault.

McCaskill has requested from U.S. Attorney General Eric Holder and U.S. Education Secretary Arne Duncan specific information and data, including how the federal government oversees reporting by colleges and universities, written guidance provided to colleges and universities and local law enforcement, information on any training provided to colleges and universities, enforcement actions by the federal government, and data on how many sexual assault cases are adjudicated administratively by universities versus how many are prosecuted in the local criminal justice system.

KANAS CITY, Mo. (AP) — A paddlefish’s lengthy trip from Mississippi ended when it was caught in the Missouri River near Kansas City.

The Missouri Department of Conservation says biologists caught, tagged and released the fish in Mississippi’s Moon Lake in March 2013. The fish was caught one year later near Levasy, Mo.

The fish was about 4.5 feet long and weighed a little more than 21 pounds — about 6 pounds less than when it was tagged in Mississippi.

Officials say another paddlefish tagged in Mississippi traveled even further up the Missouri River earlier to the Gavins Point Dam in South Dakota.

Paddlefish have a spoon-like snout and feed by filtering plankton. They can grow to longer than 7 feet and weigh more than 160 pounds

JEFFERSON CITY (AP) – The Missouri House passed legislation that would eliminate renewals on payday loans and lower the amount of interest borrowers can currently charge.

Under current law, loans can be renewed up to six times and lenders can change up to $75 in fees for a $100 loan. In Missouri, payday loans can be up to $500 and last from 14 to 31 days.

The bill also allows a borrower to sign up for additional time to pay back a loan without penalty.

Supporters say the measure protects consumers from debt. But opponents argue it doesn’t go far enough to curb irresponsible lending.

House members voted 112-39 on Tuesday to send the bill to the Senate, where a different version passed earlier. Lawmakers must agree on an identical measure by May 16.

NEOSHO, Mo. (AP) — The former treasurer of a southwest Missouri school’s Parent Teacher Organization admits she stole more than $25,000 from the group.
Twenty-nine-year-old Tabitha Lant pleaded guilty Monday to felony theft in a plea deal that would allow her to be placed on probation.

The Joplin Globe reports the plea deal includes a recommendation for a four-year suspended sentence and five years on probation, as well as restitution of $25,199 to the Seneca School District.
Sentencing was set for June 16.

A probable-cause affidavit says a review of the account found Lant made several unexplained purchases at Tropical Tan, Sam’s Club, Wal-Mart and gas stations. She told investigators she was going through a difficult divorce and needed the money for personal expenses.

On Monday Gov. Jay Nixon announced  his Missouri Health Works plan to help small businesses provide health insurance for their employees and ease burdens under the Affordable Care Act (ACA).

“Small businesses in Missouri are getting squeezed between sky-high health insurance costs and new requirements under the ACA,” Gov. Nixon said. “Unfortunately, the Missouri legislature’s inaction on Medicaid has taken this serious problem and made it worse by sending Missourians’ tax dollars to other states. There is no reason why small businesses should have to continue to bear all the burdens of the ACA and get none of the benefits. Missouri Health Works is an example of the kind of smart, business-friendly reform that is possible if we move forward and bring Missourians’ tax dollars home.”

For small employers with fewer than 150 employees, Missouri Health Works would pay a portion of employers’ health insurance costs for their employees making below 138 percent of the poverty level, or $27,310 annually for a family of three.

Under the Affordable Care Act, employees with more than 50 employees must provide affordable health insurance coverage to their employees or pay a penalty. Missouri Health Works will lessen this burden by using the dollars available through Medicaid expansion to pay for an estimated 60 percent of the cost of the health premium for eligible employees.

Missouri Health Works will also require employees to take personal responsibility by paying for a share of their health insurance costs. Eligible workers will be required to take advantage of this more cost-effective option rather than enrolling in traditional Medicaid.

Because federal funds will cover 100 percent of the costs for calendar years 2015 and 2016, funding for Missouri Health Works would involve no state tax dollars for those years. Beginning in 2017, the state share would gradually increase to no more than 10 percent of the cost in 2020.

A number of states have programs similar to Missouri Health Works in place including: Arkansas, Iowa, Kentucky, Maryland, Minnesota, Nevada, New Mexico, Oklahoma and Oregon.

Medicaid expansion and reform would bring the federal dollars that Missourians send to Washington – $2 billion a year – back to the state to provide health care coverage to 300,000 working Missourians. As a result of the legislature’s failure to act, those dollars – $5.47 million a day – are now being spent in other states. A majority of states, including Missouri’s neighboring states of Arkansas, Kentucky, Illinois and Iowa, are moving forward with plans to expand and reform Medicaid.

According to an analysis by the Missouri Economic Research and Information Center (MERIC), expanding and reforming Medicaid would result in the creation of 23,868 jobs, $9.9 billion in new wages, and $14.6 billion in new Gross State Product (GSP) from 2015 to 2022. According to the report, Medicaid expansion would also generate $402 million in new state general revenue from 2015 to 2022, including $53 million in new general revenue in 2015 alone.

In recognition of the economic benefits of this policy, 75 chambers of commerce and business groups across the state, including the Cape Girardeau Chamber of Commerce, have endorsed Medicaid expansion and reform.

By Mike Shields
KHI News Service

TOPEKA — The state’s three prime KanCare contractors each lost money in their first year managing health care for the 380,000 Kansas Medicaid enrollees, but received cash infusions from their parent companies that allowed them to meet their contract obligations and stay solvent.

That’s according to information included in the draft of the first annual report on KanCare submitted by state officials to the federal Centers for Medicare and Medicaid Services. The draft report was made public Friday afternoon as Gov. Sam Brownback was in Lenexa for a press conference describing his plan to reduce the waiting list for in-home Medicaid services using money from “KanCare dividends” the state has reaped.

It wasn’t explicit in the report how much each company lost, but references to reports filed with the National Association of Insurance Commissioners showed their collective “net operating losses” totaled more than $110 million.

“Although each health plan experienced net operating losses…each plan’s parent entity contributed adequate capital to ensure each health plan met or exceeded capital requirements as outlined in state of Kansas solvency statutes and requirements,” the report stated.

Brownback officials have put government “savings” from KanCare’s first year in the range of $55 million to $100 million, depending on how they are calculated.

KanCare is the initiative launched by Brownback on Jan. 1, 2013. It moved virtually all the state’s Medicaid enrollees into health plans run by Amerigroup, UnitedHealthcare and Sunflower State Health Plan, a subsidiary of Centene.

Budget neutrality

State officials said the report showed that Kansas exceeded the first-year requirements of CMS for the KanCare initiative, including the achievement of “budget neutrality,” which means the program didn’t cost the federal government any more than it did before the Brownback administration’s Medicaid makeover.

The federal government pays almost 60 percent of the cost of Medicaid. The state pays the rest.

When the program was launched, Brownback officials predicted that it would save the state and federal governments $1.2 billion over five years, though most of those savings were expected to come closer to the end of the five years.
Administration officials said Medicaid historically was going up at the rate of about 6.5 percent a year and their goal was to reduce the growth in cost while improving health outcomes for enrollees.

“KanCare has outperformed in its first year the estimates for savings that were made when the original KanCare proposal went in,” said Kari Bruffett, director of the Division of Health Care Finance at Kansas Department of Health and Environment, the state’s lead Medicaid agency.
The KanCare initiative has been controversial on various fronts and continues to leave many Medicaid providers, large and small, frustrated by delayed or partial payments for their services.

The report acknowledged those problems for 2013 and listed the number of appeals and grievances filed by providers with each of the managed care companies. There were more than 30,000 with Amerigroup chalking up the most.

“Amerigroup remains focused on working with all of our Kansas providers and hospital partners, and our priority is to maintain strong relationships with primary care and specialty practices, hospitals and every KanCare provider,” said Amerigroup Kansas President Laura Hopkins through a company spokesperson. “Amerigroup has a commitment to managing the KanCare program appropriately and in a sound manner on behalf of our customer, the State of Kansas.”

Persistent problems for providers

Bruffett said the administration has been working with the KanCare contractors and providers to improve the system.

“We have seen improvement, great improvement in the MCO (contractors’) interactions with providers,” she said since the program was launched, noting that the agency has been focusing in recent months on “overall improvement of the provider experience in Kancare and together with MCOs we have been focusing on that” in response to the continued concerns.

But others say the results of that effort have been mixed at best.

“Wesley has seen no marked change in recent months,” said Matt Leary, chief financial officer for Wesley Medical Center in Wichita, one of the state’s largest hospitals. “There remains ongoing communications and efforts made by all parties, but it continues to be a struggle to get timely and accurate payments.”

Other hospitals report similar problems, according to Cindy Samuelson of the Kansas Hospital Association.

“It’s hard to really answer whether it’s better overall,” she said, “because some things have improved but others have gotten worse.”

Other provider groups also described ongoing problems or inconsistent results.

“It’s just such a rabbit hole right now,” said Cindy Luxem, chief executive of the Kansas Health Care Association, a nursing home trade group.

Tammy O’Donnell, co-proprietor of a small nursing home in Easton in northeast Kansas, said it still is time consuming and often difficult to get claims correctly paid by the managed care companies, but “it has gotten a little better. It’s definitely better than it was last year. That’s for sure.”

‘Mixed bag’

Pharmacists and their associations also reported ongoing problems, though some praised efforts by KDHE pharmacy program director Kelly Melton to keep lines of communication open.

“From the durable medical equipment side of things, it’s not any better than it was from the beginning,” said Mike Conlin, who owns of Jayhawk Pharmacy and Patient Supply in Topeka. “All of the MCOs are telling people things are covered when they’re not, and then we end up in an adversarial circumstance with beneficiaries.

“It’s been my experience that their people don’t read what I call the ‘benefits grid,’” he said. ”They’ll tell a beneficiary, ‘Oh, yeah, your CPAP (continuous positive airway pressure machine) is covered,’ but they don’t tell them it’s only if they’re under 21. There have been a lot of incidents like that. It just goes on and on.”

“I would characterize it as a mixed bag,” said Mike Larkin, executive director of the Kansas Pharmacists Association said. “But I have to say that KanCare is just one of five or six fires that pharmacists are trying to put out at both the state and, primarily, the federal level with Medicare going to preferred provider networks and TRICARE making its beneficiaries get their generic maintenance medications through the mail.”

Larkin said one of his members had told him: ‘KanCare isn’t even on my radar screen anymore. I’m trying to get a drink out of one of the other fire hoses.’”

DD providers getting paid

Service providers for the developmentally disabled were some of the most vocal critics of KanCare before it was implemented and their programs were the last to be included in it. The so-called carve-in of DD long-term supports into KanCare began Feb. 1.

Tom Laing, executive director of Interhab, which represents most of the state’s Community Developmental Disability Organizations, said payments haven’t been a problem, so far, but that providers have been saddled with more administrative burden in dealing with the managed care companies.

“Folks will need to understand that we’re still in the first quarter of this changeover,” he said. “I think the state and the MCOs have done a good job in working to make sure that bills that are submitted are paid . And the administrative complexities are what we said they would be. It is more complex than it has been in the past. Our members invest more in time and energy and staffing in chasing down the bills. But bills are being paid.”

Laing said that might change once the state allows use of the billing “edits” that would otherwise have automatically applied when bills were submitted.

“We have a little bit of an artificial honeymoon right now while the new system is being made to work, Laing said. “When those edits begin to be used we’ll see some bumps certainly. I think the state is committed to doing that gradually and I think that’s pruduent. If all the edits are turned back on eventually we may find we have more problems than we currently have.”

The Legislature’s KanCare oversight committee is scheduled to meet Tuesday and is expected to hear many of the details included in the state’s draft report to CMS.

Among the report’s details:

The KanCare external evaluator recommended that the state require more detailed reporting from the KanCare contractors and consistent wording in provider surveys. Also according to the evaluator, “complete annual data for several performance measures were not available for review” due to the lag in claims processing and the “standard reporting tools.”
Native Americans were among the few Medicaid beneficiaries allowed to opt out of KanCare and remain in the old “fee-for-service” Medicaid system. In 2013, only 15 chose to opt out.
The number of Medicaid beneficiaries receiving home- and community-based services declined the first year of KanCare. There were 14,913 people on HCBS in 2012 versus 14,517 in 2013.
There were 570 new additions to the waiting list for HCBS developmental disability services in 2013 bringing the total to 3,141 people. Brownback last week announced he would ask the Legislature to fund services for 77 people using KanCare savings.
The number of children enrolled in the Children’s Health Insurance Program, which is included in KanCare, increased nearly 4 percent from 51,450 in 2012 to 56,194 in 2013.
UnitedHealthCare had the greatest number of providers in its network: 18,010. Amerigroup had 17,352 and Sunflower had 15,404.

JEFFERSON CITY, Mo. (AP) — Missouri House members have approved legislation barring state or local officials from adopting policies that infringe upon private property rights and are traceable to Agenda 21.

Agenda 21 is a nonbinding resolution adopted in 1992 by the United Nations that encouraged sustainable development. Its title is a reference to the 21st century, and it encourages changes in global consumption, management and conservation practices.

Gov. Jay Nixon vetoed the same legislation last year. The Senate approved a veto override, but the effort fell short of the necessary two-thirds majority in the House.

JEFFERSON CITY, Mo. (AP) – The Missouri Senate has endorsed a budget plan that ensures a funding increase for public education but will require negotiations with the House to hammer out the final specifics.

The plan passed Monday by the Senate would add $115 million to Missouri’s $3.1 billion in basic aid to public schools. That’s a little bit less than the House version. But both chambers would allow schools to get up to a $278 million increase if revenues meet Gov. Jay Nixon’s more optimistic projections.

The Senate plan would provide a 5 percent increase to colleges and universities. The House budget proposed a 3 percent increase for higher education, with part of that dependent upon Nixon’s higher revenue forecasts.

Legislators have until May 9 to pass a final version of the budget.