CASE MANAGEMENT SERVICES PROVIDER IN KANSAS

COORDINATING INDIVIDUALIZED CARE AND SUPPORT TO PROMOTE HEALTH, INDEPENDENCE, AND COMMUNITY INTEGRATION

Case Management Services in Kansas help individuals with disabilities, chronic conditions, or behavioral health needs navigate Medicaid services, coordinate care, and access community resources. These services are authorized under Kansas Medicaid (KanCare) through multiple Home and Community-Based Services (HCBS) waivers and behavioral health programs. The goal is to ensure services are person-centered, effective, and aligned with each participant’s unique goals.

1. GOVERNING AGENCIES

Agency: Kansas Department for Aging and Disability Services (KDADS)

Role: Oversees HCBS waiver programs and contracts with Targeted Case Management (TCM) agencies

Agency: Kansas Department of Health and Environment (KDHE) — Division of Health Care Finance

Role: Administers Medicaid provider enrollment and reimbursement for case management services

Agency: Managed Care Organizations (MCOs) under KanCare

Role: Approve case management plans, monitor service delivery, and reimburse TCM providers

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid Case Management Services comply with HCBS and TCM requirements

2. CASE MANAGEMENT SERVICE OVERVIEW

Case Management Services provide participants with assistance in planning, coordinating, and accessing services and supports necessary to live safely and independently in their communities.

Approved providers may deliver:

• Assessment of participant needs and service planning

• Development and monitoring of the Individualized Service Plan (ISP)

• Coordination with service providers, including healthcare, education, housing, and employment

• Assistance with Medicaid and waiver service access

• Crisis support and advocacy

• Transition support between service settings (e.g., hospital to home)

• Monitoring outcomes and revising plans as needed

All services must be individualized, documented in the ISP, and delivered in accordance with state-defined standards and timelines.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your agency with the Kansas Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Enroll as a Medicaid provider through the Kansas Medical Assistance Program (KMAP)

• Obtain Targeted Case Management (TCM) agency approval from KDADS (when applicable)

• Coordinate contracts with KanCare MCOs

• Maintain general liability and professional insurance

• Develop policies for service planning, coordination, documentation, and participant protection

• Ensure all case managers meet state credentialing, training, and background check requirements

4. KANSAS PROVIDER ENROLLMENT PROCESS

Initial Application:

• Apply through KMAP as a provider of Case Management or Targeted Case Management (TCM)

• Submit separate applications to KDADS for TCM certification if serving IDD or behavioral health populations

Documentation Submission:

• Submit Articles of Incorporation, EIN/NPI, proof of insurance, staff credentials, and policy manual

MCO Credentialing:

• Contract with each KanCare MCO to coordinate case management for enrolled participants

Approval & Billing Setup:

• Once approved, providers are assigned Medicaid billing codes for case management, typically billed in 15-minute units

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Kansas Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of insurance (general liability, professional)

• Case Management Services Policy & Procedure Manual, including:

  • Intake, assessment, and ISP development procedures

  • Crisis response, critical incident reporting, and care transitions

  • Documentation standards and monthly monitoring logs

  • Participant rights, informed choice, and grievance handling

  • HIPAA compliance and confidentiality policies

  • Staff credentialing, supervision protocols, and training logs

  • Medicaid billing forms and audit-ready tracking tools

6. STAFFING REQUIREMENTS

Role: Case Management Program Supervisor

Requirements: Bachelor’s or Master’s in social work, nursing, psychology, or human services; case management or supervisory experience; background check clearance

Role: Case Managers / Service Coordinators

Requirements: Bachelor’s degree in human services or related field; knowledge of Medicaid services and community resources; background screening clearance

All staff must complete:

• HIPAA and confidentiality training

• Abuse prevention and emergency response training

• Person-centered planning, ISP development, and service coordination training

• Annual continuing education and competency reviews

7. MEDICAID WAIVER PROGRAMS

Case Management Services are reimbursable under:

• Intellectual/Developmental Disability (IDD) Waiver

• Physical Disability (PD) Waiver

• Brain Injury (BI) Waiver

• Autism Waiver

• Frail Elderly (FE) Waiver

• Technology Assisted (TA) Waiver

• Children’s Mental Health Waiver

• Habilitation Services Program (for mental health coordination)

Approved providers may deliver:

• Person-centered care planning

• Crisis support and service referrals

• Ongoing service monitoring and ISP adjustments

• Cross-system coordination with medical, behavioral, and waiver service providers

8. TIMELINE TO LAUNCH

Phase: Business Formation and Policy Development

Timeline: 1–2 months

Phase: Staff Credentialing and KDADS/KMAP Enrollment

Timeline: 2–3 months

Phase: MCO Contracting and Readiness Review

Timeline: 60–90 days

Phase: Billing Setup and Case Management Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Kansas Department for Aging and Disability Services (KDADS)

Website: https://kdads.ks.gov

Kansas Department of Health and Environment (KDHE)

Website: https://www.kdhe.ks.gov

Kansas Medical Assistance Program (KMAP)

Website: https://www.kmap-state-ks.us

KanCare MCOs:

• Sunflower Health Plan: https://www.sunflowerhealthplan.com

• UnitedHealthcare Community Plan: https://www.uhccommunityplan.com/ks

• Aetna Better Health of Kansas: https://www.aetnabetterhealth.com/kansas

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KANSAS CASE MANAGEMENT PROVIDER

WCG supports care coordination agencies, disability organizations, and behavioral health providers in launching Medicaid-compliant Case Management Services across Kansas.

Scope of Work:

• Business registration, KDADS certification, and Medicaid/MCO enrollment

• Development of Case Management Policy & Procedure Manual

• Staff credentialing templates, ISP planning tools, and monitoring logs

• Medicaid billing setup and case note documentation systems

• Website, domain, and care coordination branding

• Quality assurance systems for ISP tracking, supervision, and audit readiness

• Referral network development with hospitals, waiver providers, and mental health centers

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