September 23, 2016
To: All KanCare HCBS Providers
From: Michael Randol, Director – Division of Health Care Finance
Kansas Department of Health & Environment
The Kansas Department of Health and Environment (KDHE) has contracted with Optumas, an actuary and consulting firm, to study the adequacy of Home and Community Based Services (HCBS) service payment rates. To assist with that study, Optumas has developed a financial template to be completed by all HCBS service providers. The template is available via the KanCare website, both on the home page and at the Provider Events page: http://www.kancare.ks.gov/provider_events.htm.
The template requests information on your organization’s revenue, expenses, and service delivery count. The goal of requesting this information is to assess the profit/loss position for HCBS providers and use that information to make a statement on the adequacy of HCBS service reimbursement. Revenue and service information submitted in this template will be validated against Medicaid encounter data.
It is critically important that all HCBS providers complete the template. In order for Optumas to do an effective analysis of rate adequacy, they must have this important information. If you do not complete and return the template, it could negatively impact the reliability and validity of the results. We asked Optumas to develop this compressed template approach, in lieu of the state performing a more formal and comprehensive Medicaid audit. To do a good job, we need and want Optumas to have the full and complete picture of this information from HCBS providers, so please complete the template and return it timely.
To assist with accurate template completion, Optumas will host a template review session on October 3, 2016, at 11:00 am CST. You can access the session here: https://attendee.gotowebinar.com/register/352790777909324292
During this time, they will walk through each tab and section of the template to explain how they would like providers to complete the template. Following this review, providers will be given until October 17, 2016, to complete and submit the financial template to Optumas.
Populated templates should be emailed to email@example.com and firstname.lastname@example.org. Alternatively, a hard copy of the template may be mailed to Optumas at 7400 E. McDonald Dr. Suite 101, Scottsdale, AZ 85250.
Please go to www.kancare.ks.gov, review the template, download it and start completing it. If there are any questions about the template, please bring them to the October 3 template review session. Optumas plans to use that time to explain the template in detail and then address any questions that remain.
Thank you for your cooperation with this important process.
Individuals with disabilities and the frail elderly applying for KanCare who believe they may qualify to receive long-term services and supports, Home- and Community-Based Services (HCBS), should fill out a paper application to submit to KDHE rather than apply electronically.
The paper application provides a greater amount of detail on how to apply for the Medicaid waiver in-home services, which allow people to remain in their homes and communities, as well as for medical care. You can download and print an application if you go to the link on this page:
If you think you would qualify for HCBS services, make sure you check the box on Page 4 of the print-out that asks: “Does this person need help with nursing home costs or in-home care?”
KDADS is providing consumers information regarding the Department of Labor Final Rule. Please view the DOL Consumer Information
document or visit the Department of Labor
page to view the information.