Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 12/9/2022

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2064 Failure to Cooperate - If the caretaker refuses to cooperate with CSS, Eligibility Staff will be notified by CSS via either a task in KEES or an email from the CSS staff. A penalty for failure to meet CSS requirements can be imposed only when the caretaker is referred to CSS and CSS determines the person has not cooperated.

Eligibility staff will discontinue medical assistance for the non-pregnant adult caretaker for failure to cooperate with CSS. However, medical coverage under all other categories shall be considered for such a caretaker at the time the penalty is applied. There is no penalty for other household members.

Pregnant caretakers or caretakers under the age of 19 will not be discontinued for failure to cooperate. Their cooperation status will be evaluated once they’ve reached the age of 19 or the end of the postpartum period.

Because penalties only affect coverage under the Caretaker Medical program, persons currently serving a penalty who later meet categorical requirements under another program shall have eligibility determined under the new medical program without regard to the penalty. Because penalties can result in a temporary hardship, penalties must be applied with much care and consideration. To ensure that penalties are applied uniformly and appropriately, the following guidelines must be applied in all instances of noncooperation:

2064.01 - There is documented evidence that the person was made aware of the cooperation requirement. Information provided in the approval notice fulfills this requirement.

2064.02 - There is documented evidence that the person was informed of the consequences for failing to cooperate. Information provided in the approval notice fulfills this requirement.

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