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 firstname.lastname@example.org and email@example.com. Alternatively, a hardcopy 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 3rd 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.
KDHE has developed a new method for HCBS and institutional providers who want to check on pending Medicaid / KanCare cases. Instead of calling the KanCare Clearinghouse, HCBS and Institutional providers should now request information regarding case status by sending a secure email using the process outlined below. These entities should use the new process immediately.
Please download the spreadsheet, complete all of the requested information and email it to the following address: KanCareClearinghouse@maximus.com
Once you have completed the spreadsheet, there is no need to contact us for a status check.
In order to help us identify your most important cases, please list cases on the spreadsheet in the order of importance to you. We will respond to the requests within two weeks of receiving the list. The response will indicate the status, but that does not guarantee that the application will be resolved. Continue to check MMIS or KMAP regularly to determine the results of the determination.
Some information regarding case status is only available with a release of information signed by the member. Forms authorizing the release of information are available on the KDHE website: http://www.kdheks.gov/hcf/data_requests/default.htm
Various administrative roles are available. The member should read the release carefully to ensure they understand the content of the authorization.
Instructions for Completing and Submitting a Spreadsheet:
- Complete fields in the Provider section. At a minimum, the fields in yellow must have data. Instructions for each column are at the bottom of the spreadsheet.
- It is required that you password protect your spreadsheet. If you need instructions on how to password protect your spreadsheet, please refer to the spreadsheet tab titled “Setting a Password.”
- Once you have entered data and password protected the spreadsheet, please send your spreadsheet to the following email address: KanCareClearinghouse@maximus.com
- Send a follow-up email with the password to KanCareClearinghouse@maximus.com
NOTE: If a spreadsheet is sent without password protection or without the follow up email containing the password, we will be unable to assist.