Medicaid Backlog Climbing Again
The Medicaid application backlog in Kansas appears to be on its way up, after initial progress in tackling underlying factors that drove the crisis that started about a year ago. If your organization is...
Sunflower Annual and Quarterly HCPCS Code Change
In cooperation with KDHE and with regards to benefit and pricing determinations, Sunflower Health Plan will make annual and quarterly HCPCS code changes, including additions, revisions and deletions, effective with dates of service on...
Change to CCRC Status
Many members have been working on becoming CCRCs in order to lower their provider assessment. Questions about the timing of this change and the resulting change in provider assessment rate have come up.
The key date for...
Clarification: CCRC Status Changes Decreases Tax Rate and Net Medicaid Dollars, But Not Medicaid...
In the Aging Update article entitled “Change to CCRC Status”, posted on January 11, 2017, we stated, “… a change to CCRC status will lower your provider assessment rate, it will also lower your...
PEAK Incentive Rates
Similar to changes in provider assessment rates, PEAK incentives that are earned (or taken away) are effective July 1st for the whole next year. Members who have had issues this year with PEAK progress...
2015 Navigator Issues
After the release of our latest Medicaid Cost Report Navigator we found that several homes were not included. Upon checking with KDADS it was found that there was a problem with the data file...
Elderly and Persons with Disabilities KanCare Eligibility Application Guide
The Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF) has released a guide to assist the Elderly and Persons with Disabilities (E&D) in completing an Application for Medical Assistance...
Medicare Crossover Claim Processing Changes
To comply with the Centers for Medicare & Medicaid Services (CMS) Managed Care regulations at Federal Register § 438.3(t), States that use the automated crossover process must require managed care organizations (MCOs) to...
KanCare Application Checklist Now Available
The State has released a 2-page KanCare Application checklist as a tool for long-term care providers to assist people applying for Medicaid/KanCare. Please use and share widely. Thank you to the LeadingAge Kansas members...
Acuity-Based Staffing
We’ve all started hearing about acuity-based staffing and that we are going to be judged on it for Value Based Purchasing and in future survey models, but what is acuity-based staffing?
Because residents have...
KanCare – For Sunflower-Specific Questions
Keep this Sunflower Provider Relations Territory Map on your desk! It provides contact info for the person you need to reach out to with all of your Sunflower-specific questions or concerns.
UnitedHealthcare Claims Payment Issue
United Healthcare recently identified a claims payment issue where they incorrectly paid claims from October through December at an old rate for many facilities. This only affects homes that had a retro rate change for...