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Aetna Shakes Up Kansas Leadership After Chronic Complaints Put Its Medicaid Contract at Risk

Kansas Medicaid insurer Aetna has come under fire for delayed payments to doctors and others. (Photo by Chris Neal, for the Kansas News Service)

TOPEKA — Aetna is bringing in new leadership to run its Medicaid operations in Kansas after chronic complaints from hospitals and others put it at risk of losing its contract.

The Kansas Department of Health and Environment confirmed Friday that Aetna Better Health of Kansas CEO Keith Wisdom is no longer in that role. But the insurer declined to answer questions about whether it had replaced Wisdom.

“As part of our commitment to the State of Kansas, we’re bringing in additional leaders with extensive experience in Medicaid,” the company wrote in a brief emailed statement. The changes will “help us effectively support the needs of this population.”

Aetna, which insures 100,000 Kansans on Medicaid, would not identify its new hires. It has ignored repeated requests for interviews in recent weeks since Kansas put the company on notice in late July for failing to comply with its contract.

KDHE’s Medicaid director was traveling Friday and could not be reached for more details, but an agency spokeswoman said Aetna informed Kansas of the changes last week.

State officials have spoken to the new leaders, spokeswoman Ashley Jones-Wisner said, “and they have a clear understanding regarding our expectations in order to come into compliance.”

Complaints against Aetna Better Health of Kansas range from lack of transparency about which health providers they’ll cover to delays and mistakes in payments to doctors and hospitals. Providers say Aetna’s repeated promises to fix the problems haven’t panned out.

Aetna submitted a plan to Kansas in early August to come into compliance, but officials at the Kansas State Department of Health and Environment said the plan failed to address the concerns. Since then, state officials have met with Aetna.

On Monday and Tuesday, both sides will give a public update to a panel of lawmakers in Topeka.

The Kansas Medicaid program mostly serves low-income children, but also parents, pregnant women, people with disabilities and seniors in long-term care. The state privatized its Medicaid, dubbing it KanCare, in 2013.

The original three companies faced complaints similar to those that Aetna now faces. One of them, Amerigroup, lost its contract to Aetna last year in a bidding process. Aetna’s contract began early this year.

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Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service.  Follow her on Twitter @Celia_LJ.  The Kansas News Service is a collaboration of Kansas Public Radio, KCUR, KMUW and High Plains Public Radio - focused on the health and well-being of Kansans, their communities and civic life.

 

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