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Directors and managers, don’t forget that our next mandatory Learning Collaborative is scheduled for April 18th at 3:00 p.m. We look forward to seeing you there!
WSU-CEI will host its next Community of Practice session for Social Workers and Care Coordinators on May 16th at 3:00pm. Please keep a look out for the invitation to the next Community of Practice event.
This month, the state team has revised United Healthcare's OneCare Kansas postal address in Appendices A and B of the OCK Program Manual. These Appendices contain general contact information and OCK program forms. The updated OCK program forms detailed below are available in the OCK Program Manual and the KanCare website under OCK Forms section.
Please refer to the OCK Program Manual on the following pages to view the updated OneCare Kansas postal address for United Healthcare.
- Appendix A, Page 32: Contact Information
- Appendix B, Page 63: Refusal Form
- Appendix B, Page 64: Member Discharge Notification Form
- Appendix B, Page 65: Referral Form
- Appendix B, Page 66: Member Opt-Out Form
Medicaid annual reviews have begun. With the unwinding of the continuous eligibility requirement, Kansans who have Medicaid for their health coverage will go through a review process to determine their eligibility. This review process is to ensure members receiving benefits continue receiving the appropriate level of care.
Eligibility reviews will take place over a 12-month period. It is important for members to keep their contact information up to date to ensure they receive notifications about the annual review process and the month they will be reviewed. Members can update their contact information with the KanCare Clearinghouse at 1-800-792-4884 or by using the chatbot KIERA on the KanCare website.
On March 13, 2023, the first round of review letters and forms were distributed to members, with a deadline of April 15, 2023. If a review form is misplaced, the member can call the KanCare Clearinghouse or submit an online application. If the member does not return the form by the deadline, they will receive an additional letter informing them that their case will be closed by the end of their review month.
Members have the option to complete the Medicaid application online by creating an account with the Medical Consumer Self-Service portal. Once the members account is created, they can log in and complete their online review by selecting the Access my KanCare icon.
KanCare performs three types of annual reviews, as detailed below.
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Pre-populated reviews only include a form that is pre-populated with the members information that KanCare already has on file, as well as sections for reporting changes and new household information. This form must be signed, dated, and submitted to the KanCare Clearinghouse by the deadline. If the form is not submitted by the deadline, the member will receive a letter informing them of the date their case will be closed.
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Passive reviews contain both a passive review letter and form. The letter informs the member of their eligibility as determined by the computer system interface and the form is printed with the member's information that KanCare has on file. The member must promptly contact the KanCare Clearinghouse if their information is incorrect.
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Super passive reviews only contain a super passive letter explaining the members eligibility. There are no forms to complete and submit for this type of review.
If a member receives a notification that they do not qualify for KanCare, they may be able to obtain health insurance coverage through the Health Insurance Marketplace. Most Marketplace plans provide services such as prescription drugs, doctor visits, urgent care, and hospital visits. Members can search for Marketplace plans by visiting HealthCare.gov.
As eligibility reviews continue, it is critical that the KanCare Clearinghouse have the most recent contact information for the members. This will help the KanCare Clearinghouse notify members when their renewal is due. Please refer to the KanCare website and a recent press release issued by the Kansas Department of Health and Environment (KDHE) for additional information regarding KanCare annual eligibility reviews.
The OCK state team would like to draw attention to the Kansas Medicaid spenddown program and its impact on Medicaid eligibility, and thus eligibility for services under the OneCare Kansas program (OCK).
Individuals in Kansas must meet certain income requirements to be eligible for Medicaid. The spenddown program, also known as the medically needy program, is an option to consider for those whose income exceeds the Medicaid eligibility income standard but who still have high medical expenses. This program allows individuals to “spend down” their excess income by paying for certain medical expenses out of pocket for the applicable spenddown period until they meet the Medicaid eligibility requirement. This is referred to as the spenddown amount and is similar to an insurance deductible. Once the spenddown amount is met, the individual becomes eligible for Medicaid coverage for the duration of the spenddown period, which is typically six months.
The spenddown amount is different for every individual or family and is calculated based on the countable income of the individual and their family over the protected income limit. Some medical expenses, such as doctor and hospital bills, prescription drug costs, and transportation expenses used to receive medical care, can be deducted from the spenddown amount. Individuals must keep track of their medical expenses each period to satisfy the spenddown program requirements.
When the spenddown amount has been satisfied for the relevant spenddown period, the individual may become eligible for OCK services if they have a qualifying diagnosis that meets the requirements of the OCK program. A member is no longer eligible to receive OCK services if their Medicaid coverage is terminated because of an unmet spenddown amount. In this case, OneCare Kansas Partners (OCKP) are not required to complete an OCK Discharge Form for the member.
Before delivering OCK services, OCKP's must ensure that members have met their spenddown amount. The MCO portal and KMAP both allow OCKP’s to verify the status of members to ensure the spenddown is met. A member's status should always be verified in KMAP or the MCO portal, but as the public health emergency unwinds, this verification step has become even more important as certain OCK members may lose Medicaid coverage.
The spenddown program can be a lifeline for individuals whose income is above the Medicaid eligibility standard but still need assistance with healthcare expenses. By allowing individuals to deduct healthcare expenses from their excess income each period, the spenddown program can help more individuals receive the healthcare services they need, including OCK services. It is important for both the member and the OCKP’s to ensure that the member's spenddown is met each period so they can access Medicaid coverage and the services they may need. For more information on spenddowns, please refer to the OCK Program Manual and the Spenddown – Medically Needy Fact Sheet.
Maintaining good eye health is essential to an individual’s overall health and wellbeing. The risk of developing eye diseases increases with age. To reduce the impact of possible disease and injury and preserve one's vision it is important to identify one's risk and make healthy choices to protect eye health.
Understanding one's risk for developing eye disease is crucial as there may be an underlying problem even though one's eyes appear to be in good health. Certain eye diseases are more likely to develop in people who are overweight or obese, have a family history of eye disease, or are African American, Native American, or Hispanic. Diabetes puts some people at risk for diabetic retinopathy, which can cause vision loss and blindness. Individuals who are at risk of developing eye disease can take actions to minimize their risk and protect their vision from harm by using the following tips:
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Schedule routine dilated eye exams.
- Routine eye exams are painless and important for maintaining good eye health. Routine eye exams can detect early signs of eye diseases and conditions.
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Eat a healthy diet.
- Eating a healthy diet rich in vitamins and nutrients can reduce the risk of disease and other conditions that can contribute to vision problems. Foods such as leafy greens and fish high in omega 3 fatty acids are good for maintaining healthy eyes.
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Engage in physical activity.
- Staying active can reduce the risk of health conditions such as high cholesterol, which may cause eye health or vision problems.
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Quit smoking.
- Smoking increases eye irritation and the risk of developing eye diseases, such as macular degeneration, cataracts, and optic nerve damage. Quitting smoking can help prevent or delay the onset of these conditions.
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Take screen breaks.
- Those who spend a lot of time looking at computer or phone screens should rest their eyes by taking regular breaks every 20 minutes.
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Wear sunglasses.
- Wearing sunglasses that block 99 to 100 percent of both UVA and UVB radiation, even on cloudy days, is recommended to reduce the risk of developing certain eye diseases.
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Use protective eyewear.
- Wearing safety glasses and goggles when participating in activities such as sports, construction jobs, or home maintenance can protect one's eyes from injury.
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Avoid eye infections.
- Those who wear contacts can prevent eye infections by washing their hands often, disinfecting their contacts, and replacing them on a regular basis.
Taking care of one’s eyes is an important part of overall health and wellbeing. By understanding one’s risk for disease and following these tips, individuals can promote good eye health and preserve healthy vision. For more information on eye health, visit the Keeping Your Eyes Healthy article on the National Eye Institute’s website.
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