Kansas Administrative Code

Delivery of managed care. Counties shall be selected by the secretary pur- suant to K.S.A. 1994 Supp. 39-7,112, as amend- ed, to participate in managed care service deliv- ery options. Subject to provider availability, any beneficiary may be required to choose a managed care opti…

(AuthorizedbyK.S.A.1975Supp.39- 708c; effective Jan. 1, 1967; revoked May 1, 1976.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amend- ed Jan. 1, 1971; amended, E-72-1, Oct. 1, 1971; amended, E-72-3, Nov. 5, 1971; amended Jan 1, 1972;amended,E-72-12,March31,1972;amend- ed Jan. 1, 1973; am…

(Authorized by K.S.A. 1975 Supp. 39- 708c; effective Jan. 1, 1967; amended Jan. 1, 1971; amended, E-71-34, Aug. 11, 1971; amended Jan. 1, 1972;amendedJan.1,1974;revokedMay1,1976.) 31 30-5-26 Medicaid Program

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amend- ed Jan. 1, 1971; amended, E-72-1, Oct. 1, 1971; amended, E-72-3, Nov. 5, 1971; amended Jan. 1, 1972; amended Jan. 1, 1973; amended Jan. 1, 1974; amended M…

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amend- ed Jan. 1, 1971; amended, E-72-1, Oct. 1, 1971; amended Jan. 1, 1972; amended Jan. 1, 1973; amended Jan. 1, 1974; amended, E-77-36, July 1, 1976;amendedFe…

(Authorized by K.S.A. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amended, E-70- 37, Aug. 5, 1970; amended Jan. 1, 1971; revoked, E-72-23, July 28, 1972; revoked Jan. 1, 1973.)

(Authorized by K.S.A. 1978 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; revoked, E-79-20, Aug. 17, 1978; re- voked May 1, 1979.)

(Authorized by K.S.A. 1976 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; revoked Feb. 15, 1977.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amend- ed Jan. 1, 1971; amended, E-72-1, Oct. 1, 1971; amended Jan. 1, 1972; amended Feb. 15, 1977; amended, E-79-20, Aug. 17, 1978; amended May 1, 1979; revoked…

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1967; amended, E-70-9, Dec. 4, 1969; amended, E-70-37, Aug. 5, 1970; amended Jan. 1, 1971; amended, E-72-1, Oct. 1, 32 DEPARTMENT FOR CHILDREN AND FAMILIES 30-5-27 1971; amended Jan. 1, 1972; amended, E-77-36, July 1, 19…

(Authorized by K.S.A. 1971 Supp. 39-708; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-37, Aug. 5, 1970; amend- ed Jan. 1, 1971; amended, E-72-1, Oct. 1, 1971; amended Jan. 1, 1972; revoked, E-72-23, July 28, 1972; revoked Jan. 1, 1973.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended Jan. 1, 1974; amended, E-79-20, Aug. 17, 1978; amended May 1, 1979; amended, E-81-19, July 16, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 1970 Supp. 39-708; effective Jan. 1, 1967; amended Jan. 1, 1968; amended, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; revoked Jan. 1, 1974.)

(Authorized by K.S.A. 1969 Supp. 39-708; effective Jan. 1, 1967; amended, E-70-9, Dec. 4, 1969; revoked Jan. 1, 1971.) 30-5-4 to 30-5-9. (Authorized by K.S.A. 1965 Supp. 39-708; effective Jan. 1, 1967; revoked Jan. 1, 1971.)

(Authorized by K.S.A. 1970 Supp. 39-708; effective Jan. 1, 1967; revoked, E-70-9, Dec. 4, 1969; revoked Jan. 1, 1971.)

Definitions. (a) The following words and terms for home- and community-based services (HCBS), when used in this article, shall have the following meanings, unless the context clearly indicates otherwise. (1) “Accept medicare assignment” means that the provider will accept the med…

Provider participation.(a)Each provider shall meet the provider participation re- quirements specified in K.A.R. 30-5-59, including record keeping requirements, and the following additional requirements: (1) All assessment records; (2) All plan of care records; and (3) All case f…

Limitations for independent living counselors. (a) An independent living center shall not use any consumer as an inde- pendent living counselor when that consumer re- ceives services from the same independent living counseling agency. (b) This regulation shall take effect on and …

Cost effectiveness. (a) Except for “cost cap” approvals, each HCBS plan of care shall be cost-effective. (b) This regulation shall take effect on and after January 1, 1997. (Authorized by and implement- ing K.S.A. 1995 Supp. 39-708c, as amended by L. 1996, Ch. 229, Sec. 104; effe…

Cost efficient plans of care. (a) Each HCBS plan of care shall be cost efficient and shallbeprovidedinaccordancewithK.A.R.30-5-70. (b) This regulation shall take effect on and after January 1, 1997. (Authorized by and implement- ing K.S.A. 1995 Supp. 39-708c, as amended by L. 199…

Assessment requirements. (a) Qualified staff and assessment providers shall con- duct an assessment prior to the implementation of any HCBS service. (b) This regulation shall take effect on and after January 1, 1997. (Authorized by and implement- ing K.S.A. 1995 Supp. 39-708c, as…

Effective date for HCBS eli- gibility. (a) The effective date of eligibility for HCBS services shall not be before the effective date of medicaid eligibility. (b) This regulation shall take effect on and af- ter January 1, 1997. (Authorized by and imple- menting K.S.A. 1995 Supp.…

Family reimbursement restric- tion. (a) Neither an adult consumer’s spouse nor a minor consumer’s parents shall be paid to provide HCBS services to that consumer, unless all other possible options are exhausted and one of the fol- lowing extraordinary criteria is met. (1) Three H…

Nonsupplementation of HCBS services. (a) An organization, agency, family, con- sumer, or other individual shall not be allowed to pay for services that are on the plan of care. (b) A consumer may accept the following: (1) Any available service that is provided free and voluntaril…

Scope of and reimbursement for medicaid home- and community-based services (HCBS). The scope of medicaid home- and community-based services shall consist of those services provided under the authority of the applicable federally approved waiver to the Kan- sas medicaid state plan…

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1969; amended, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; amended, E- 72-1,Oct.1,1971;amended,E-72-3,Nov.5,1971; amended Jan. 1, 1972; amended, E-72-12, March 31, 1972; amended Jan. 1, 1973; amended Jan. 1, 1974; amende…

Scope and reimbursement for home- and community-based services for per- sons with a severe emotional disturbance. (a) Thescopeofhome-andcommunity-basedservices for persons with a severe emotional disturbance shall consist of those services provided under the authority of the appl…

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1969; amended, E-70- 9, Dec. 4, 1969; amended Jan. 1, 1971; amend- ed, E 72-1, Oct. 1, 1971; amended Jan. 1, 1972; amended Jan. 1, 1973; amended Jan. 1, 1974; amended May 1, 1975; amended Feb. 15, 1977; amended, E-78-19,…

(Authorized by K.S.A. 1980 Supp. 39-708c; effective Jan. 1, 1969; amended, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; amended, E- 72-1, Oct. 1, 1971; amended Jan. 1, 1972; amend- ed Jan. 1, 1974; amended May 1, 1975; amended Feb. 15, 1977; amended, E-79-20, Aug. 17, 1978; amende…

(Authorized by K.S.A. 1980 Supp. 39-708c, 75-3304; effective Jan. 1, 1969; amend- ed, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; amended, E-72-1, Oct. 1, 1971; amended, E-72-3, Nov. 5, 1971; amended, E-72-12, March 31, 1972; amended Jan. 1, 1973; amended Jan. 1, 1974; amended Ma…

(Authorized by K.S.A. 1970 Supp. 39-708; effective Jan. 1, 1969; revoked, E-70-9, Dec. 4, 1969; revoked Jan. 1, 1971.)

(Authorized by K.S.A. 75-5321; ef- fective Jan. 1, 1974; revoked May 1, 1981.) 30-5-37 and 30-5-38. (Authorized by K.S.A. 75-5321, 75-5375(s), K.S.A. 1980 Supp. 39-708c, 39-748; effective, E-78-19, July 8, 1977; effective May 1, 1978; revoked May 1, 1981.)

(Authorized by K.S.A. 75-5321, K.S.A. 1980 Supp. 39-708c, 39-748; effective, E-78-19, July 8, 1977; amended, E-79-1, Feb. 1, 1978; effective May 1, 1978; amended, E-79-20, Aug. 17, 1978; amended May 1, 1979; amended, E-81-19, July 16, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective, E-78-19, July 8, 1977; effective May 1, 1978; amended, E-79-20, Aug. 17, 1978; amended May 1, 1979; amended, E-80-13, Aug. 8, 1979; amended May 1, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 75-5321, 75- 5375(s), K.S.A. 1980 Supp. 39-708c, 39-748; ef- fective, E-78-19, July 8, 1977; amended, E-79-1, Feb. 1, 1978; effective May 1, 1978; amended, E-79-20, Aug. 17, 1978; amended May 1, 1979; revoked May 1, 1981.)

(Authorized by K.S.A. 75-5321, K.S.A. 1980 Supp. 39-708c, 39-748; effective, E-79-1, Feb. 1, 1978; effective May 1, 1978; re- voked May 1, 1981.) 33 30-5-58 Medicaid Program

(Authorized by K.S.A. 1980 Supp. 39-708c; effective, E-79-30, Nov. 21, 1978; ef- fective May 1, 1979; amended, E-81-25, Aug. 27, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective, E-79-33, Dec. 20, 1978; ef- fective May 1, 1979; amended, E-81-25, Aug. 27, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective, E-79-30, Nov. 21, 1978; ef- fective May 1, 1979; amended, E-80-13, Aug. 8, 1979; amended May 1, 1980; amended, E-81-25, Aug. 27, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective, E-79-30, Nov. 21, 1978; ef- fective May 1, 1979; amended, E-81-19, July 16, 1980; revoked May 1, 1981.)

(Authorized by K.S.A. 1980 Supp. 39-708c; effective, E-79-30, Nov. 21, 1978; effec- tiveMay1,1979;amended,E-80-13,Aug.8,1979; amended May 1, 1980; revoked May 1, 1981.) 30-5-48 to 30-5-50. (Authorized by K.S.A. 1980 Supp. 39-708c; effective May 1, 1980; re- voked May 1, 1981.) 30…

Definitions. The following words and terms, when used in this article, shall have the following meanings, unless the context clearly indicates otherwise. (a) “Accept medicare assignment” means the provider will accept the medicare-allowed pay- ment rate as payment in full for ser…

Provider participation require- ments. The following shall be prerequisites for participation in and payment from the medicaid/ medikan program. Any provider of services to fos- ter care consumers, adoption support consumers, Kan Be Healthy consumers, or other consumers who have …

Provider termination/suspension. (a) Any provider’s participation in the medicaid/ medikan program may be terminated for one or more of the following reasons: (1) Voluntary withdrawal of the provider from participation in the program; (2) non-compliance with applicable state laws…

(Authorized by K.S.A. 1979 Supp. 39-708c; effective May 1, 1981; amended, T-84- 11, July 1, 1983; revoked May 1, 1984.)

Withholding of payments to medical providers. (a) Payments otherwise au- thorized to be made to medical providers shall be withheld, in full or in part, by the agency when: (1) The agency has determined that the provid- er to whom payments are to be made has been overpaid; (2) th…

Suspension of payment lia- bility to medical providers. (a) Suspension of payment liability because of determination by the secretary of health and human services. The agency shall suspend payment liability for ser- vices provided by any medical provider during any time period in…

Reinstatement of a provider previously terminated from the medicaid/ medikan program. A request for reinstatement by a provider terminated from participation in the medicaid/medikan program shall not be consid- ered for a period of 60 days following the effective date of the orde…

Medical necessity. Except as spe- cifically set forth in program policy, the agency shall not reimburse a provider for the provision of acoveredservicetoaprogramrecipientunlessthe provision of the service was medically necessary. (Authorized by and implementing K.S.A. 1985 Supp. …