KanCare & Medicaid
The Division of Health Care Finance (DHCF) is responsible for purchasing health services for children, pregnant women, people with disabilities, the aged, and the elderly through the Medicaid program, the Children's Health Insurance Program (CHIP), and the state-funded MediKan program. On average, about 360,000 Kansas are enrolled in these programs each month.
Health services are purchased through either a managed care model or a fee-for-service model. The KanCare program is the State of Kansas' managed care program. KanCare is provided to all Medicaid and CHIP consumers. Kansas has contracted with three health plans, or managed care organizations (MCOs), to coordinate health care for nearly all beneficiaries. The KanCare program began in January 2013. The KanCare health plans are Aetna Better Health of Kansas (Aetna), Sunflower State Health Plan (Sunflower), and UnitedHealthcare Community Plan of Kansas (United). For more information about KanCare, please visit the KanCare website.
In the fee-for-service model, the State pays the provider directly for medical services. The following Kansas programs are not in KanCare and are paid through the fee-for-service model.
|Program Name||Program Description|
This program is for persons who do not meet citizenship rules. It covers life-threatening emergency care costs and baby deliveries only.
This program is for persons with disabilities who do not qualify for Medicaid. MediKan has limited services.
Program for All-Inclusive Care for the Elderly (PACE)
This program provides long-term care through a managed care network but is not part of the KanCare network. This is a program for persons age 55 or older living in select Kansas counties.
Tuberculosis - (TB)
This is the name of the program that provides coverage for individuals diagnosed with Tuberculosis. The Kansas Department of Health and Environment (KDHE) provides case management and limited medical assistance. Coverage is limited to inpatient hospital care or necessary alternative community-based care as approved KDHE. No other services or items, such as prescriptions are covered.
Medicare Savings Plans
These programs pay Medicare out-of-pocket expenses. This includes premiums and co-payments.
AIDS Drug Assistance Program (ADAP) only
This program provides payment of prescription drugs related to the treatment of HIV.
Many people with disabilities want to work but worry that doing so could jeopardize their vital health and long-term care coverage. Working Healthy offers people with disabilities who are working or interested in working the opportunity to get or keep Medicaid coverage while on the job. Through Working Healthy people can earn more, save more, achieve their career goals, and still maintain their health coverage.
Citizenship and Identity Verification for Federally Funded Medical Benefits: Are you applying for federally funded medical benefits? If so, the following links will inform you more about federal requirements for applications that were added in July 2007.
- Fact Sheet
- Federally Funded Medical Benefits Federal Citizenship Requirements (PDF)
- Center on Budget Policy and Priorities report on Medicaid citizenship documentation requirement
- Local Education Agencies Frequently Asked Questions (PDF)
- Hospital Payments: Transition to MS-DRGs - January 2009 (PDF)
- Disproportionate Share Hospital (DSH) Program - May 2008
- Providers Address for Claims and Refunds (PDF)
Section 6032 of the Deficit Reduction Act (PDF) - KMAP Providers and Entities who make or receive $5 million or more in annual KMAP payments are subject to the provisions of Section 6032 of the Deficit Reduction Act. This Provision relates to "Employee Education About False Claims Recovery."
For assistance with Medicaid Subrogation (KSA 39-719a claims), please contact Health Management Systems (HMS) Kansas Estate Recovery Contractor via email or phone at 800-817-8617 or fax at 785-271-9318.
Local Education Agencies
- 2009 Spring Supplemental Billing Packet Local Education Agency Professional Claims (PDF)
- Kansas School District Administrative Claiming (SDAC) Presentation (PDF)
- Kansas School Enrollment (PDF)
- KHPA Cost Settlement Letter (PDF)
- Local Education Agency FAQs 2009 (PDF)
- Provider Electronic Solutions Local Education Agency Professional Claims (PDF)
- SDAC Inter-Agency Agreement (PDF)
- SPL Training (PDF)