reglab/statecodes huggingface dataset:
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-60 - Living in a public institution

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Definition.
			 "Public institution" means any institution that is the responsibility of a
			 governmental unit or over which a governmental unit exercises administrative
			 control.
(b) Living arrangement.
			 Each applicant or recipient living in a public institution shall be ineligible
			 for assistance, except that any otherwise eligible recipient admitted to a
			 public institution for short term medical care or diagnosis shall be eligible
			 for assistance, if needed, for a period not to exceed three months. Any
			 individual who is physically residing in a jail or penitentiary or under the
			 care, custody and control of a law enforcement official shall be ineligible
			 unless the individual is on probation, parole, or on bail.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-61 - Supplemental security income benefits

Current through Register Vol. 43, No. 28, July 11, 2024
(a) An applicant or
			 recipient receiving supplemental security income benefits shall be ineligible
			 for assistance. A caretaker shall not be denied eligibility for assistance for
			 the reason that a child is receiving supplemental security income benefits.
			 This provision shall not be applicable to a foster care child placed in a
			 foster family home.
(b) This
			 regulation shall take effect on and after March 1, 1997.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-64 - Work program requirements for TANF

Current through Register Vol. 43, No. 28, July 11, 2024
Each applicant or recipient of TANF, unless exempted, shall be
				required to participate in one or more components of the work program. Any
				exempt applicant or recipient may volunteer for participation in the program.
				The geographic areas in the state and the public assistance programs in which
				work program requirements are to be enforced shall be designated by the
				secretary. The administration of the work program shall be within the limits of
				appropriations.
(a) Exemptions. The
			 following persons shall be exempt from the work requirements:
(1) Any person who is aged 17 or younger or
			 who is aged 18 and working toward attainment of a high school diploma or its
			 equivalent. This exemption shall not be claimed by a female who is pregnant or
			 a parent of a child in the home and who has not yet attained a high school
			 diploma or its equivalent;
(2) any
			 person who is needed in the household because another member of the household
			 requires the person's presence due to illness or incapacity and no other
			 appropriate member of the household is available to provide the needed care;
			 and
(3) any parent or other
			 caretaker who is personally providing care for a child under the age of three
			 months. Only one person in a case may be exempt on the basis of providing care
			 for a child under the age of three months. This exemption shall not be claimed
			 under any of the following circumstances:
(A)
			 A custodial parent or pregnant woman under the age of 20 does not possess a
			 high school diploma or its equivalent;
(B) both parents, a stepparent, a cohabiting
			 partner, or a caretaker of the child is present and is not exempt, unsuitable,
			 or incapable of providing child care; or
(C) a parent, a stepparent, a cohabitating
			 partner, or a caretaker is determined to have a substance abuse
			 disorder.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-70 - Eligibility factors specific to the TAF program

Current through Register Vol. 43, No. 28, July 11, 2024
To be eligible for TAF, each applicant or recipient shall meet
				the applicable general eligibility requirements of
				K.A.R.
				30-4-50 and the specific eligibility
				requirements set forth below.
(a)
(1) Child in family. To be eligible for TAF,
			 the applicant's or recipient's family group shall include at least one eligible
			 child. If the only child in the family group is an SSI recipient, the family
			 group may qualify for assistance.
(2) For purposes of this regulation, "child"
			 means a child who meets either of these requirements:
(A) is under the age of 18, including an
			 unborn child; or
(B) is age 18 and
			 in secondary school or working towards the attainment of a GED.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-80 - Eligibility factors specific to the FFP-FC program

Current through Register Vol. 43, No. 28, July 11, 2024
Each child, as defined in
				K.A.R.
				30-4-70, shall meet the eligibility
				requirements set forth below. In addition, if the child of an FFP-FC recipient
				and the FFP-FC recipient are living together in the same foster care living
				arrangement, the recipient's child shall be deemed to meet the eligibility
				requirements of the FFP-FC program.
(a) General eligibility requirements. Each
			 child shall meet the general eligibility requirements of K.A.R. 30-4-50.
(b) Removed from the home of a
			 relative. The child shall have been removed from the home of a relative as a
			 result of a judicial determination, or the child shall have lived with the
			 relative within six months before the month in which the proceedings were
			 initiated and shall have been placed in a foster home or child care facility as
			 a result of this determination.
(c) Child in need. The child's eligibility
			 shall be determined on a calendar-month basis. Total budgetary requirements
			 shall be compared with total applicable income. If there is a deficit, the
			 child shall be determined to be in need if the child owns property with a value
			 not in excess of allowable limits.
(d) Court order. A written order of
			 commitment shall be issued giving the secretary care, custody, and control of
			 the child.
(e) Case plan. The
			 child shall have a case plan designed to achieve placement in the least
			 restrictive setting available and in close proximity to the parents' home. The
			 case plan shall be consistent with the best interest and special needs of the
			 child.
(f) Administrative review.
			 The child's status shall be reviewed periodically but not less than once every
			 six months. The review shall be open to the participation of the parents of the
			 child. The review shall be conducted by a panel of appropriate persons. The
			 panel shall include at least one person who is not responsible for the case
			 management of either the child or the parents under review. The administrative
			 review shall determine the future status of the child including whether the
			 child should be returned to the parent, continued in foster care for a
			 specified period, placed for adoption, or continued in foster care on a
			 permanent or long-term basis.
(g)
			 Living arrangement. The child shall be living in a foster family home or a
			 private, nonprofit child care facility. The home or facility shall be approved
			 by the agency for placement.
(h)
			 This regulation shall take effect on and after March 1, 1997.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-95 - Eligibility factors specific to the non-FFP-FC program

Current through Register Vol. 43, No. 28, July 11, 2024
Each child shall meet the eligibility requirements set forth
				below to be eligible for the non-FFP-FC program.
(a) A written order of commitment without
			 guardianship shall have been issued giving the secretary care, custody, and
			 control of the child.
(b) The
			 child shall meet one of the following conditions:
(1) Is under the age of 18;
(2) Is under the age of 21 and a full-time
			 student in a secondary school or equivalent level of vocational or technical
			 training; or
(3) Is under the age
			 of 21 and participating in an approved independent living plan.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-98 - Funeral assistance

Current through Register Vol. 43, No. 28, July 11, 2024
Assistance may be provided for funeral expenses upon the death
				of a recipient at the discretion of the secretary.
(a) Funeral expenses. Funeral expenses may
			 include the cost of any of the following, based on available resources and the
			 requirements in this regulation:
(1) The
			 preparation of the body;
(2) a
			 minimal casket or urn;
(3) the
			 transportation of the body within Kansas; or
(4) a cremation.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-100 - Payment standards for the TANF and foster care programs

Current through Register Vol. 43, No. 28, July 11, 2024
(a) The basic and
			 shelter standards in
			 K.A.R.
			 30-4-101 and
			 30-4-102,
			 and the designated special requirements in
			 K.A.R.
			 30-4-120, shall be used in determining the
			 total benefit amount for the TANF and foster care programs. An applicant or
			 recipient shall not be eligible to have a standard included in the computation
			 of the applicant's or recipient's benefit amount if the department or another
			 state's assistance program has issued the applicant or recipient a payment for
			 the same maintenance items in the same calendar month.
(b) The benefit amount for the TANF and
			 foster care programs shall be based upon the total number of persons in each
			 assistance plan.
(1) The basic standard and
			 100% of the shelter standard shall be used under each of the following
			 circumstances:
(A) All persons in the home are
			 in the same assistance plan.
(B)
			 The only person in the home not in the plan is an SSI recipient to whom the
			 one-third SSI reduction is applied because the person lives in the household
			 and receives support and maintenance in kind.
(C) There is a bona fide commercial
			 landlord-tenant relationship between the family group and the other persons in
			 the home.
(D) All persons in the
			 plan are in a commercial board and room or commercial room-only living
			 arrangement or are residing in nonmedical living arrangements that are publicly
			 funded or are funded by not-for-profit agencies or organizations, including
			 temporary homeless shelters, alcohol or drug abuse treatment facilities, and
			 shelters for battered persons.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-101 - Standards for persons in own home, other family home, specialized living, commercial board and room, or commercial room-only living arrangements

Current through Register Vol. 43, No. 28, July 11, 2024
A monetary standard shall be deemed to address the costs of
				day-to-day expenses and certain special expenditures.
(a) Basic standard. The basic standards shall
			 be those set forth below. The basic standards include $18.00 per person as an
			 energy supplement.
PERSONS IN PLAN
1 2 3 4
$132.00 $217.00 $294.00 $362.00
(b) Shelter standard. A standard has been
			 established for shelter based on location in the state. The shelter standards
			 shall be those set forth below for each county.
Group I
Standard.
$92.00
Allen Gove Norton
Anderson Graham Osborne
Atchison Grant Ottawa
Barber Greeley Phillips
Barton Greenwood Pottawatomie
Bourbon Hamilton Pratt
Brown Harper Rawlins
Chase Haskell Republic
Chautauqua Hodgeman Rooks
Cherokee Jackson Rush
Cheyenne Jewell Russell
Clark Kearny Saline
Clay Kingman Scott
Cloud Labette Sheridan
Coffey Lane Smith
Comanche Lincoln Stafford
Cowley Linn Stanton
Crawford Logan Stevens
Decatur Lyon Sumner
Dickinson Marion Thomas
Doniphan Marshall Trego
Edwards Meade Wabaunsee
Elk Mitchell Wallace
Ellis Montgomery Washington
Ellsworth Morris Wichita
Finney Nemaha Wilson
Ford Neosho Woodson
Geary Ness
Group II Group III Group IV
Standard. $97.00 $109.00 $135.00
Franklin Butler Douglas
Gray Jefferson Harvey
Kiowa Leavenworth Johnson
Morton McPherson
Pawnee Miami
Seward Osage
Sherman Reno
Rice
Riley
Sedgwick
Shawnee
Wyandotte
(c) This regulation shall take effect on and
			 after March 1, 1997.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-102 - Standards for children in foster care

Current through Register Vol. 43, No. 28, July 11, 2024
The standards below shall be used for children in foster care.
(a) The cost of care for any child
			 placed in a care facility shall be an amount established by the secretary.
(b) The foster care standards
			 shall also be used to meet the maintenance needs of a child of a foster care
			 recipient if the recipient and the child are living together in the same foster
			 care living arrangement.
(c) This
			 regulation shall take effect on and after March 1, 1997.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-106 - General rules for consideration of resources, including real property, personal property, and income

Current through Register Vol. 43, No. 28, July 11, 2024
(a) For purposes of
			 determining eligibility for assistance, ownership of property shall be
			 determined by legal title. In the absence of a legal title, ownership shall be
			 determined by possession.
(b)
			 Resources, to be real, shall be of a nature that the value can be defined and
			 measured. The value of resources shall be established by the objective
			 measurements set forth in paragraphs (1) and (2) below.
(1) Real property. The value of real property
			 shall be initially determined by the latest uniform statewide appraisal value
			 of the property, which shall be adjusted to reflect current market value. If
			 the property has not been appraised or if the market value as determined above
			 is not satisfactory to the applicant or recipient or the agency, an estimate or
			 appraisal of its value shall be obtained from a disinterested real estate
			 broker. The cost of obtaining an estimate or appraisal shall be borne by the
			 agency.
(2) Personal property. The
			 market value of personal property shall be initially determined by a reputable
			 trade publication. If a publication is not available, or if there is a
			 difference of opinion regarding the value of the property between the applicant
			 or recipient and the agency, an estimate from a reputable dealer shall be used.
			 The cost of obtaining an estimate or appraisal shall be borne by the agency.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-107 - Property exemption

Current through Register Vol. 43, No. 28, July 11, 2024
Any assistance family may own otherwise nonexempt real or
				personal property with an aggregate resource value that shall not exceed the
				amounts prescribed by the secretary of the United States department of health
				and human services pursuant to
				7 U.S.C.
				2014(c). Ownership of
				property with a resource value in excess of this amount shall render the
				assistance family group ineligible for assistance. However, if there is
				ineligibility due to excess real property, assistance shall be provided for a
				period of up to nine months if the applicant or recipient is making a bona fide
				and documented effort to dispose of the property.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-108 - Real property

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Definitions.
(1) "Home" means the house or shelter in
			 which the applicant or recipient is living or from which the applicant or
			 recipient is temporarily absent, as well as the tract of land and contiguous
			 tracts of land upon which the house and other improvements essential to the use
			 or enjoyment of the home or located. Tracts of land shall be considered to be
			 contiguous if lying side by side, except for streets, alleys, or other
			 easements. The home shall not include pieces of property that touch only at the
			 corners.
(2) "Other real property"
			 means any of the following types of property:
(A) real property other than a home;
(B) a home from which an applicant
			 or recipient has been temporarily absent for at least 12 months; or
(C) a home to which an applicant or recipient
			 will be unable to return.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-109 - Personal property

Current through Register Vol. 43, No. 28, July 11, 2024
(a)
			 Definitions for TANF and food assistance programs.
(1) "Cash assets" shall mean money,
			 investments, and cash surrender or loan values of life insurance policies,
			 trust funds, and similar items on which a determinate amount of money can be
			 realized.
(2) "Personal property"
			 shall mean personal effects, household equipment and furnishings, home produce,
			 livestock, equipment, vehicles, inventory, contracts from the sale of property,
			 and similar items on which a determinate amount of money can be realized. This
			 term shall not include real property.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-110 - Income

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Definitions.
(1) "Earned income" means income, in cash or
			 in kind, that an applicant or recipient currently earns, through the receipt of
			 wages, salary, or profit, from activities in which the individual engages as an
			 employer or as an employee with responsibilities that necessitate continuing
			 activity on the individual's part.
(2) "Unearned income" means all income not
			 earned.
(3) "Lump sum" means a
			 nonrecurring payment.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-111 - Income

Current through Register Vol. 43, No. 28, July 11, 2024
(a) "Income" shall
			 mean the amount of earned and unearned income that is subtracted from the
			 benefit standard in determining the benefit amount for TANF.
(b) Earned income for persons included in the
			 assistance plan shall equal gross earned income or the adjusted gross earned
			 income from self-employment, less the following items:
(1) Ninety dollars for each employed
			 person;
(2) the earned income
			 disregard of 60 percent of the remaining income, for the following persons in a
			 TANF or foster care assistance plan:
(A) Each
			 applicant who had received assistance in one of the four preceding months;
			 and
(B) each recipient;
			 and
(3) reasonable
			 expenses for child care or expenses for the care of an incapacitated person.
			 The dependent shall be included in the family group before the deduction is
			 allowed.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-113 - Exempt income

Current through Register Vol. 43, No. 28, July 11, 2024
The following types of income shall be exempt in the
				determination of the budgetary deficit:
(a) For TANF, earned income of a child who is
			 under the age of 19 years if the child is a student in elementary or secondary
			 school or is working towards attainment of a GED;
(b) for food assistance, earned income of a
			 child who is under the age of 18 years if the child is a student in elementary
			 or secondary school or is working towards attainment of a GED;
(c) lump sum income;
(d) irregular, occasional, or unpredictable
			 monetary gifts that do not exceed $50.00 per month per family group;
(e) income-in-kind;
(f) shelter cost participation payments. In
			 shared living arrangements in which two families contribute toward the shelter
			 obligations, any cash paid toward the shared shelter obligation by one family
			 to the second family in the shared arrangement shall not be considered as
			 income to the second family. This exemption shall not be applicable in a bona
			 fide, commercial landlord-tenant arrangement;
(g) tax refunds and rebates, except for
			 earned income tax credits in accordance with
			 K.A.R.
			 30-4-112;
(h) incentive payments received by renal
			 dialysis patients;
(i) home energy
			 assistance furnished on the basis of need by a federally regulated or
			 state-regulated entity whose revenues are primarily derived on a rate-of-return
			 basis, by a private, nonprofit organization, by a supplier of home heating oil
			 or gas, or by a municipal utility company that provides home energy;
(j) income received from the job training
			 partnership act of 1982. However, earnings received by individuals who are
			 participating in on-the-job training programs shall be countable unless the
			 individual is a child;
(k) housing
			 assistance from federal housing programs;
(l) assistance payments in the month
			 received;
(m) support payments
			 received following the effective date of the assignment of support rights to
			 the department. However, a support refund disbursed by the department to the
			 recipient or reported current support that, if prospectively treated as
			 nonexempt income, would result in ineligibility, shall not be exempt
			 income;
(n) up to $2,000.00 per
			 year of income received by an individual Indian that is derived from leases or
			 other uses of an individually owned trust or restricted lands;
(o) veterans administration (VA) payments
			 resulting from unusual medical expenses, which shall mean expenditures
			 exceeding five percent of the veteran's reported annual income;
(p) interest income that does not exceed
			 $50.00 per month per family group; and
(q) the amount of any child support
			 pass-through payment.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-130 - Types of payments and payees

Current through Register Vol. 43, No. 28, July 11, 2024
Public assistance payments shall be issued in accordance with
				this regulation.
(a) Money payment.
(1) Payments shall be available through the
			 state electronic benefit transfer system or, in certain circumstances, by check
			 or writen order immediately redeemable at face value. Payments shall be made
			 with no restriction on the use of the funds, except TANF payments.
(2) All payments shall be money payments,
			 except for the following types of payments:
(A) Payments pursuant to the foster care
			 programs; and
(B) work program
			 support costs and transitional expenses in accordance with
			 K.A.R.
			 30-4-64(c) and
			 (d).
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 4 - PUBLIC ASSISTANCE PROGRAM › Section 30-4-140 - Payments; penalties; enforcement

Current through Register Vol. 43, No. 28, July 11, 2024
(a)
Assistance payments shall equal the budgetary deficit, which
				shall be rounded down to the nearest dollar, except as follows:
(1) Payments for the month of application
			 shall equal the budgetary deficit, which shall be prorated beginning with the
			 date of application through the end of the month. This amount shall be rounded
			 down to the nearest dollar.
(2) A
			 payment shall not be made if the amount of the budgetary deficit is less than
			 $10.00. If a payment is not made under this paragraph, recipient status shall
			 continue.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-60 - Provider termination/suspension

Current through Register Vol. 43, No. 28, July 11, 2024
(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, administrative regulations, or program issuances concerning medical
			 providers;
(3) non-compliance with
			 the terms of a provider agreement;
(4) non-compliance with the terms and
			 certification set forth on claims submitted to the agency for reimbursement;
(5) assignment, granting a power
			 of attorney over, or otherwise transferring right to payment of program claims
			 except as set forth in 42 U.S.C. 1396a (32), revised July 18, 1984, which is
			 adopted by reference;
(6) pattern
			 of submitting inaccurate billings or cost reports;
(7) pattern of submitting billings for
			 services not covered under the program;
(8) pattern of unnecessary utilization;
(9) unethical or unprofessional
			 conduct;
(10) suspension or
			 termination of license, registration, or certification;
(11) provision of goods, services, or
			 supplies harmful to individuals or of an inferior quality;
(12) civil or criminal fraud against
			 medicare, the Kansas medicaid/medikan or social service programs, or any other
			 state's medicaid or social service programs;
(13) suspension or exclusion by the secretary
			 of health and human services from the title XVIII or title XIX programs;
(14) direct or indirect ownership
			 or controlling interest of five percent or more in a provider institution,
			 organization or agency by a person who has been found guilty of civil or
			 criminal fraud against the medicare program or the Kansas medicaid/medikan or
			 social service programs or any other state's medicaid or social service
			 programs;
(15) employment or
			 appointment by a provider of a person in a managerial capacity or as an agent
			 if the person has been found guilty of civil or criminal fraud against the
			 medicare program or the Kansas medicaid/medikan or social service programs or
			 any other state's medicaid or social service programs;
(16) insolvency; or
(17) other good cause.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-61a - Withholding of payments to medical providers

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Payments
			 otherwise authorized 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 provider to whom payments are to be made has
			 been overpaid;
(2) the agency has
			 reliable evidence, although additional evidence may be needed for a
			 determination, that an overpayment exists or that the payment to be made may
			 not be correct; or
(3) the agency
			 has been instructed by the department of health and human services (HHS) to
			 withhold all or part of the federal share from payment to a medical provider.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-61b - Suspension of payment liability to medical providers

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Suspension of
			 payment liability because of determination by the secretary of health and human
			 services. The agency shall suspend payment liability for services provided by
			 any medical provider during any time period in which payments may not be made
			 to the provider under titles XVIII or XIX of the social security act because of
			 a determination by the secretary of health and human services pursuant to 42
			 U.S.C.A. 1395y(d)(1) and (e)(1), clause (C)(ii), (D), (E) or (F) of 42 U.S.C.A.
			 1395cc (b)(2). The suspension shall be effective upon receipt of the
			 notification of the determination by the department of health and human
			 services (HHS) and shall remain in effect until the agency is otherwise
			 notified by HHS. The agency, no later than the effective date of the
			 suspension, shall send written notification of the suspension and the reasons
			 therefore to the affected medical provider. No payment shall be made to any
			 medical provider for services provided by the medical provider during the time
			 period of suspension unless the agency receives notification from HHS to do
			 otherwise.
(b) Suspension of
			 payment liability upon notification of proposed termination.
(1) Payment liability may be suspended by the
			 agency upon notification to a provider of a proposed termination if the
			 provider may no longer legally provide services or for other good cause. No
			 payment shall be made to a provider for services rendered after the provider
			 receives notification of the suspension.
(2) If payment liability is suspended to an
			 adult care home, payment liability for those program recipients who are living
			 in the home at the time of the suspension may be continued, for a period not to
			 exceed 30 days, to facilitate the orderly transfer of the recipients to another
			 facility or to alternate care.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-62 - Reinstatement of a provider previously terminated from the medicaid/medikan program

Current through Register Vol. 43, No. 28, July 11, 2024
A request for reinstatement by a provider terminated from
				participation in the medicaid/medikan program shall not be considered for a
				period of 60 days following the effective date of the order of termination. As
				a prerequisite for reinstatement in the program one or more of the following
				conditions may be imposed by the agency:
(a) Implementation and documentation of
			 corrective action taken by the provider to comply with program policies and to
			 reasonably insure that the reason for the termination shall not recur;
(b) probationary period not to
			 exceed one year;
(c) attendance at
			 provider education sessions;
(d)
			 prior authorization of services;
(e) peer supervision; and
(f) other conditions as the specific
			 situation may warrant.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-63 - Medical necessity

Current through Register Vol. 43, No. 28, July 11, 2024
Except as specifically set forth in program policy, the agency
				shall not reimburse a provider for the provision of a covered service to a
				program recipient unless the provision of the service was medically necessary.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-66 - Effective date of administrative regulations in relationship to provider cost reporting periods

Current through Register Vol. 43, No. 28, July 11, 2024
The administrative regulations in effect at the beginning of a
				cost reporting period shall govern the treatment of costs that accrue during
				said period unless otherwise provided.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-67 - Disallowance of claims for services generated by providers ineligible for participation in the medicaid/medikan program

Current through Register Vol. 43, No. 28, July 11, 2024
The agency shall disallow payment, except for emergency
				services, if the service set forth on a claim was generated by a provider
				ineligible to participate in the medicaid/medikan program.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-68 - Consultants to the medicaid/medikan program

Current through Register Vol. 43, No. 28, July 11, 2024
Consultants to the medicaid/medikan program may be reimbursed
				if under contract with the Kansas department of social and rehabilitation
				services. The payment rate for consultants shall be a mutually negotiated
				amount. The effective date of this reguation shall be August 1, 1990.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-69 - Volume purchase and negotiated contracts for medical services

Current through Register Vol. 43, No. 28, July 11, 2024
The agency may procure medical services from a single or
				multiple source through competitive bidding or negotiated fee. The agreed upon
				reimbursement shall supersede the usual reimbursement methodology for the
				service.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-70 - Payment of medical expenses for eligible recipients

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Payment for
			 covered services shall be made only to those providers participating in the
			 program pursuant to K.A.R. 30-5-59. The only exceptions shall be pursuant to
			 K.A.R. 30-5-65.
(b) Each program
			 recipient shall be eligible for the payment of specific medical expenses as
			 follows:
(1) Payment of Medicare (title
			 XVIII) premiums and deductibles and co-insurance amounts for services covered
			 in the medicaid program. Recipients who are ineligible for program coverage
			 because they have a spenddown shall be eligible for the payment of the Medicare
			 (title XVIII) premium expense. For cash recipients, including SSI recipients,
			 who are age 65 or older, payment of the Medicare (title XVIII) premium shall
			 begin with the month of approval for medicaid, excluding any months of prior
			 eligibility. For recipients under age 65 who are eligible for Medicare after
			 receiving retirement and survivor's disability insurance for 24 consecutive
			 months, payment of the Medicare (title XVIII) premium shall begin with the 25th
			 month. For all other recipients, payment of the Medicare (title XVIII) premium
			 shall begin with the second month following the month of approval for medicaid,
			 excluding any months of prior eligibility;
(2) payment of premiums of health maintenance
			 organizations that are approved by the agency or premiums of group health plans
			 offered by the recipient's employer if the agency has determined that this plan
			 is cost-effective;
(3) payment of
			 other allowable medical expenses incurred in the current eligibility base
			 period in excess of any co-pay or spenddown requirements;
(4) payment for services rendered to a person
			 who is mandated to receive inpatient treatment for tuberculosis and who is not
			 otherwise eligible for participation in the program. Coverage shall be limited
			 to services related to the treatment for tuberculosis;
(5) payment for services in excess of
			 medicaid/medikan program limitations for foster care and adoption support
			 recipients, when approved by the agency; and
(6) payment for covered medical services
			 provided to an individual participating in the KanWork program. A monthly
			 cost-sharing amount for medical services shall be paid by each individual
			 participating in the KanWork program when required.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-71 - Copayment requirements

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Except as set
			 forth in subsection (b) of this regulation, program recipients shall be
			 obligated to the provider for the following copayment charges.
(1) The copayment for inpatient general
			 hospital and freestanding psychiatric facility services shall be $48.00 per
			 admission.
(2) The copayment for
			 outpatient general hospital services shall be $1.00 per non-emergency visit in
			 place of a doctor's office visit.
(3) The copayment for other medical services
			 subject to copayment shall be based upon the following ranges:
average medicaid/medikan payment for services maximum copayment
				chargeable to recipient
$10.00 or less $.50
$10.01 to $25.00 $1.00
$25.01 to $50.00 $2.00
$50.01 or more $3.00
(4) The copayment for other medical services
			 subject to copayment shall be a standard amount based upon the average medicaid
			 payment for the services, calculated on an annual basis. The average medicaid
			 payment shall be calculated by dividing the cost of the services in aggregate
			 by the total number of claims paid in the previous fiscal year. Any change in
			 copayment shall be published in the Kansas Register on or before December
			 fifteenth to be effective January first of each year.
(5) Other medical services subject to
			 copayment shall include the following:
(A)
			 Ambulatory surgical center services, for each date of service;
(B) audiological services, excluding
			 batteries, for each date of service;
(C) community mental health center services,
			 for each individual psychotherapy visit;
(D) durable medical equipment, prosthetics,
			 and orthotics, for each claim, excluding the rental of durable medical
			 equipment;
(E) home health
			 services, for each skilled nursing visit, excluding the rental of durable
			 medical equipment;
(F)
			 non-emergency ambulance services, for each date of service;
(G) optometric or opthalmologist services,
			 for each date of service;
(H)
			 outpatient general hospital surgery, for each date of service;
(I) prescribed drugs, for each new or
			 refilled prescription;
(J)
			 physician or physician extender services, for each office visit;
(K) podiatric services, for each office
			 visit;
(L) psychological services,
			 for each office visit;
(M)
			 dietician services, for each date of service;
(N) dental services, for each date of
			 service;
(O) federally qualified
			 health center services, for each encounter; and
(P) rural health clinic services, for each
			 encounter.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-72 - Medical contracts; funding

Current through Register Vol. 43, No. 28, July 11, 2024
All medical contracts shall be subject to federal and state
				funding conditioned by appropriations made by congress and the state
				legislature.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-73 - Requirements for facilities to participate

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Medical
			 services provided in community mental health centers, free-standing psychiatric
			 facilities, state-operated hospitals, and general hospitals to be reimbursed by
			 the medicaid/medikan program shall be under the effective control of a
			 physician as determined by the agency.
(b) Community mental health centers,
			 free-standing psychiatric facilities, state-operated hospitals, and general
			 hospitals providing medical services reimbursable by the medicaid/medikan
			 program shall have utilization review programs approved by medicare or the
			 agency. Utilization review programs and their implementation shall be subject
			 to review by the secretary.
(c)
			 Facilities offering medical services shall be licensed or certified by an
			 appropriate Kansas state licensing or certification authority in order to be
			 eligible for reimbursement by the medicaid/medikan program. The effective date
			 of this regulation shall be October 1, 1993.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-75 - Scope of services for eligible aliens

Current through Register Vol. 43, No. 28, July 11, 2024
The scope of services shall be limited to emergency medical
				services for otherwise eligible aliens pursuant to
				K.A.R.
				30-6-54 who do not qualify under the
				citizenship and alienage requirements.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-76 - Scope of coverage and reimbursement for services for qualified medicare beneficiaries

Current through Register Vol. 43, No. 28, July 11, 2024
The scope of coverage for QMBs shall be the reimbursement of
				medicare premiums and coinsurance under part A and part B of medicare, for
				covered and noncovered medicaid/medikan services. The reimbursement rates shall
				be based upon the methodologies specified in this article, and the combination
				of medicare and medicaid payments shall not exceed payments at the current
				medicaid/medikan reimbursement rates. If the medicare payment exceeds the
				payment at the current medicaid/medikan reimbursement rate, no further payment
				shall be made. Reimbursement rates for services not otherwise covered by
				medicaid/medikan shall not exceed 80 percent of the current medicare allowable
				reimbursement rates or shall be determined by the secretary. This regulation
				shall be effective on and after January 1, 2002.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-77 - Scope of home-and community-based services for technology-assisted children

Current through Register Vol. 43, No. 28, July 11, 2024
The scope of home-and community-based services for
				technology-assisted children shall consist of those services provided under the
				authority of a federally approved waiver. Home-and community-based services
				shall be provided in accordance with a written plan of care by a home health
				agency and approved by the Kansas department of social and rehabilitation
				services.
(a) Services may include
			 one or more of the following:
(1) An average
			 of 10 hours per month of case management services;
(2) a maximum of seven days or 168 hours per
			 calendar year of respite care provided in the home; and
(3) medical equipment and supplies not
			 otherwise covered under the medicaid program and approved in the plan of care.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-79 - Scope of and reimbursement for home-and community-based services for persons with mental retardation or other developmental disabilities

Current through Register Vol. 43, No. 28, July 11, 2024
The scope of home-and community-based services for persons with
				mental retardation or other developmental disabilities shall consist of those
				services provided under the authority of the applicable federally-approved
				waiver to the Kansas medicaid state plan.
(a) Prior to the development of any plan to
			 provide services, the need for services shall be determined by an
			 individualized assessment of the prospective recipient by a provider of
			 community-based screening services.
(b) Home-and community-based services shall
			 be provided in accordance with an individualized, written plan of care approved
			 in writing by the Kansas department of social and rehabilitation services. Each
			 annual review and amendment of this plan shall be approved in the same fashion.
			 This plan shall:
(1) Be based on needs
			 identified during the screening assessment;
(2) specify each service to be provided and
			 why each service was selected, or how each service will address any specific
			 need identified by the assessment;
(3) specify the frequency, and within what
			 limits, each service shall be provided;
(4) specify what other support services are
			 required and the plan for obtaining them;
(5) be prepared in consultation with the
			 recipient or the recipient's guardian, if one has been appointed;
(6) be approved in writing by the recipient
			 or the recipient's guardian, as appropriate; and
(7) be reviewed at least annually and updated
			 as necessary.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-80 - This regulation shall be revoked on and after July 1, 1997

Current through Register Vol. 43, No. 28, July 11, 2024
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-81 - Scope of hospital services

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Each hospital
			 shall be medicare-certified and shall annually update medicaid enrollment
			 information.
(b) Outpatient
			 services shall be covered with the following limitations.
(1) Services shall be ordered by an attending
			 physician who is not serving as an emergency room physician, except for those
			 services related to emergency situations. Orders shall be related specifically
			 to the present diagnosis of the recipient.
(2) A prosthetic device shall replace all or
			 part of an internal body organ or shall replace one of these devices.
(3)
(A) Rehabilitative therapies shall be
			 restorative in nature.
(B)
			 Rehabilitative therapies shall be provided following physical debilitation due
			 to acute physical trauma or physical illness.
(C) Rehabilitative therapies shall be
			 prescribed by the attending physician.
(4) Services provided in the emergency
			 department shall be emergency services.
(5) Elective surgery shall not be covered,
			 except for sterilization operations or operations for Kan Be Healthy program
			 participants.
(6) Ambulance
			 services shall not be covered.
(7)
			 Nonemergency visits in place of physician office visits shall be considered
			 physician office visits and shall be counted against the physician office visit
			 limitation.
(8) Outpatient
			 hospital assessment of the need for emergency service shall not be covered.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM › Section 30-5-81a - Participation in the diagnosis related group reimbursement system

Current through Register Vol. 43, No. 28, July 11, 2024
As a prerequisite for participation in the medicaid/medikan
				program, a general hospital shall participate in the Kansas department of
				social and rehabilitation services' diagnosis related group reimbursement
				system. The effective date of this regulation shall be January 1, 1989.