Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 9/16/2021

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01600 General Information about Other Programs and Miscellaneous -

1601 Case Records - Case records are required for all assistance cases and are to be separate from social service records. The eligibility record shall include required forms to establish eligibility for assistance and additional information and decisions reached regarding eligibility, the type of assistance, notices to the client, and authorization forms.

The case record includes all information about all individuals on a case. The case record is comprised of three (3) main components: 1) All information input into KEES, 2) The eligibility record held on KEES, and 3) information and documentation in the case file.

The eligibility record is the output of KEES which is transferred to the MMIS for claims payment and MCO assignment. All data input is a part of the eligibility and case record.

The case file is the collection of documents that support the information contained in the state eligibility system as well as all other documentation that relates to the case. Any information received, in any format, in relation to a case must be in the case file. The case file contains all documentation supporting the case processing activities, such as application forms, income verification and worksheets, correspondence, legal documents, requests for case maintenance, a log of case actions and customer contacts, and previous eligibility information for the household.

1601.01 Correspondence - Notices affecting the eligibility shall become a permanent part of the agency's record. Notices sent through KEES are maintained in KEES. Off-system notices are imaged to the case file.

(1) - Content of Notices - All notices should contain sufficient information to make clear their purpose, the information desired, and how the information is to be used. The wording should be clear, direct, and adequate to cover the subject. Care should be taken to avoid misunderstanding or misinterpretation.

(2) - Filing - Letters from clients are to be retained if they contain significant material.

(3) - Letters, newspaper clippings, and other material, should be dated and properly identified.

1602 Disposition of Obsolete Case Record Material - Destroy any material which is older than 36 months and is not currently in effect on active cases with the following exceptions:

(1) - The last application which opened the case;

(2) - For AABD cases converted to SSI (whether open for medical or not), the application and budget in effect for December 1973 must be retained indefinitely;

(3) - Retain indefinitely all documentation needed to establish current eligibility such as income verification, tax filing status, etc;

(4) - Retain indefinitely a copy of the individual's Social Security card when it has been provided. In addition, the PA-3120.4 (Welfare Enumeration) form and copies of all documents used for enumeration purposes shall also be maintained indefinitely;

(5) - Retain indefinitely all material pertaining to unrecovered overpayments, including all documentation for the amount and cause of the overpayment;

(6) - Retain indefinitely all material pertaining to verification of the immigration status of aliens;

(7) - Retain indefinitely all materials pertaining to documentation of common-law marriages or paternity;

(8) - Retain indefinitely all documents used to verify citizenship and identity of the individual, including the ES-3850.

1602.01 Disposition of Closed Cases - Closed medical cases may be destroyed after they have been closed for 36 months except for (1) all material pertaining to unrecovered overpayments, or (2) cases that have a designated period of ineligibility which exceeds the retention period (e.g.; first time conviction of fraud, etc.)

1603 Voter Registration - The National Voter Registration Act of 1995 requires voter registration to be available in public assistance offices. The Act also requires that anyone applying for or receiving public assistance, including Medicaid, be offered the opportunity to register to vote at the time of initial application, each eligibility review, and each report of a change of address. Each individual must be informed of this registration service and offered assistance in completing the voter registration form or declining the registration activity. The KC1100, Medical Assistance Application for Families with Children and the KC1500, Medical Assistance Application for the Elderly and Persons with Disabilities offers everyone the opportunity to register to vote or to decline to register. Completion of the voter registration question is not a condition of eligibility for assistance. If an individual does not complete this section of the application, it is considered an indication of voter registration. An answer of “Yes”, “No” or blank in the Voter Registration section has no bearing on case processing or eligibility. Those applying on-line are offered the opportunity to link to the Secretary of State's voter registration site. All those who answer "yes" are to be handed or mailed a voter registration application. Voter Registration forms can be returned to KanCare and will be sent to the corresponding Secretary of State’s Office within five (5) days of receipt.

1604 Estate Recovery - The estate recovery program has been established as a means to recover medical care costs from the estates and property of certain medical assistance recipients. See Medical-KEESM 1725

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