Kansas Administrative Regulations › Agency 129 - KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT-DIVISION OF HEALTH CARE FINANCE › Article 10 - ADULT CARE HOME PROGRAM › Section 129-10-15a - Reimbursement

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Each provider
			 with a current signed provider agreement shall be paid a per diem rate for
			 services furnished to Kansas medical assistance-eligible residents. Payment
			 shall be for the type of medical or health care required by the resident, as
			 determined by the attending physician's or physician extender's certification
			 upon admission, and the individual's level of care needs, as determined through
			 assessment and reassessment. However, payment for services shall not exceed the
			 type of care that the provider is certified to provide under the Kansas medical
			 assistance program. The type of care required by the resident may be verified
			 by the agency before and after payment.
(b) Payment for routine services and
			 supplies, pursuant to K.A.R. 30-10-1a, shall be included in the per diem
			 reimbursement. No provider shall otherwise bill or be reimbursed for these
			 services and supplies.
(1) The durable
			 medical equipment, medical supplies, and other items and services specified in
			 paragraphs (b)(1)(A) through (OOO) shall be considered routine for each
			 resident to attain and maintain the highest practicable physical and
			 psychosocial well-being, in accordance with the comprehensive assessment and
			 plan of care. No provider shall bill or be reimbursed for the following
			 separately from the per diem rate:
(A)
			 Alternating pressure pads and pumps;
(B) armboards;
(C) bedpans, urinals, and basins;
(D) bed rails, beds, mattresses, and mattress
			 covers;
(E) blood glucose monitors
			 and supplies;
(F) canes;
(G) commodes;
(H) compressors;
(I) crutches;
(J) denture cups;
(K) dialysis, including supplies and
			 maintenance, if the service is provided in the facility by facility staff;
(L) dressing items, including
			 applicators, tongue blades, tape, gauze, bandages, adhesive bandages, pads,
			 compresses, elasticized bandages, petroleum jelly gauze, cotton balls, slings,
			 triangle bandages, pressure pads, and tracheostomy care kits;
(M) emesis basins and bath basins;
(N) enemas and enema equipment;
(O) extra nursing care and supplies;
(P) facial tissues and toilet
			 paper;
(Q) first-aid ointments and
			 similar ointments;
(R) footboards;
(S) foot cradles;
(T) gel pads or cushions;
(U) geriatric chairs;
(V) gloves, rubber or plastic;
(W) heating pads;
(X) heat lamps and examination lights;
(Y) humidifiers;
(Z) ice bags and hot water bottles;
(AA) intermittent
			 positive-pressure breathing (IPPB) machines;
(BB) irrigation solution, both water and
			 normal saline;
(CC) IV stands,
			 clamps, and tubing;
(DD) laundry,
			 including personal laundry;
(EE)
			 laxatives;
(FF) lifts;
(GG) lotions, creams, and powders, including
			 baby lotion, oil, and powders;
(HH) maintenance care for residents who have
			 head injuries;
(II) mouthwash;
(JJ) nebulizers;
(KK) nonemergency transportation;
(LL) nutritional supplements;
(MM) occupational therapy;
(NN) orthoses and splints to prevent or
			 correct contractures;
(OO)
			 over-the-counter analgesics and antacids taken for the occasional relief of
			 pain or discomfort, as needed;
(PP) over-the-counter vitamins;
(QQ) oxygen, masks, stands, tubing,
			 regulators, hoses, catheters, cannulae, humidifiers, concentrators, and
			 canisters;
(RR) parenteral and
			 enteral infusion pumps;
(SS)
			 patient gowns, pajamas, and bed linens;
(TT) physical therapy;
(UU) respiratory therapy;
(VV) restraints;
(WW) sheepskins and foam pads;
(XX) skin antiseptics, including alcohol;
(YY) speech therapy;
(ZZ) sphygmomanometers, stethoscopes, and
			 other examination equipment;
(AAA)
			 stool softeners;
(BBB) stretchers;
(CCC) suction pumps and tubing;
(DDD) syringes and needles;
(EEE) thermometers;
(FFF) traction apparatus and equipment;
(GGG) underpads and adult diapers,
			 disposable or nondisposable;
(HHH)
			 walkers;
(III) water pitchers,
			 glasses, and straws;
(JJJ)
			 weighing scales;
(KKK)
			 wheelchairs;
(LLL) urinary
			 supplies, urinary catheters, and accessories;
(MMM) total nutritional replacement therapy;
(NNN) gradient compression
			 stockings; and
(OOO) ostomy
			 supplies.