Kansas - Transitional Assistance Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Kansas Department for Aging and Disability Services (KDADS) oversees Transitional Assistance Services (TAS) under the state’s Frail Elderly (FE), Physical Disability (PD), and Traumatic Brain Injury (TBI) waivers to fund one-time household setup expenses for Medicaid members leaving institutional care. Providers coordinate the purchase of essential furnishings, security deposits, and utility connections to establish a member's independent community residence.

Approval to bill for these transition expenses requires an active Kansas Medical Assistance Program (KMAP) provider ID and fully executed network contracts with at least one of the three KanCare Managed Care Organizations (MCOs). Applicants must first pass KDADS background checks and obtain a KMAP ID before any KanCare MCO will accept a credentialing application for TAS reimbursement.

1. Service Definition and Scope

Transitional Assistance Services in Kansas cover the one-time, necessary expenses required to establish a basic household when a KanCare member transitions from a nursing facility or intermediate care facility into a community setting. The service is strictly limited to setup costs and cannot be used for ongoing living expenses.

All purchases must be explicitly detailed in the member's Person-Centered Service Plan (PCSP) and approved by the KanCare MCO prior to the expenditure.

• Covered Expenses: security deposits, utility connection fees, basic furniture, and moving company costs.
• Excluded Items: monthly rent, food, electronics, recreational items, and ongoing utility charges.
• Lifetime Cap: limited to a strict lifetime maximum per member (typically $1,500 to $2,000 depending on the specific waiver or Money Follows the Person program).
• Target Population: KanCare members transitioning from an institutional setting to a private community residence.
• Service Authorization: requires prior authorization from the member's KanCare MCO care coordinator before any funds are spent.

2. Regulatory and Oversight Agencies

The Kansas Department for Aging and Disability Services (KDADS) sets the policy and provider qualifications for all HCBS waivers. The Kansas Department of Health and Environment (KDHE) acts as the single state Medicaid agency.

Day-to-day administration, prior authorization, and claims payment are handled by the three KanCare Managed Care Organizations (MCOs).

• Kansas Department for Aging and Disability Services (KDADS): manages HCBS waiver policy and provider qualifications (https://kdads.ks.gov).
• Kansas Department of Health and Environment (KDHE): serves as the single state Medicaid agency (https://www.kdhe.ks.gov).
• Kansas Medical Assistance Program (KMAP): processes the initial Medicaid provider enrollment (https://www.kmap-state-ks.us).
• Aetna Better Health of Kansas: KanCare MCO requiring separate network contracting (https://www.aetnabetterhealth.com/kansas).
• Sunflower Health Plan: KanCare MCO requiring separate network contracting (https://www.sunflowerhealthplan.com).
• UnitedHealthcare Community Plan of Kansas: KanCare MCO requiring separate network contracting (https://www.uhccommunityplan.com/ks).

3. Gatekeeping Prerequisites: Who Can Even Apply

Kansas does not require a Certificate of Need for TAS, but it heavily restricts who can provide it based on the target population and managed care networks. Providers cannot bill for this service simply by enrolling in Medicaid; they must secure MCO contracts.

For providers targeting the I/DD population, local affiliation is a hard prerequisite before state enrollment is even possible.

• KanCare MCO Network Status: providers must secure a contract with Aetna, Sunflower, or UnitedHealthcare; out-of-network TAS is only permitted via single-case agreements.
• CDDO Affiliation (I/DD Waiver only): applicants targeting the I/DD population must secure a signed affiliation agreement with the local Community Developmental Disability Organization (CDDO) before KMAP enrollment.
• KMAP Enrollment: mandatory prerequisite before any MCO will process a credentialing application.
• Business Registration: applicants must be registered and in good standing with the Kansas Secretary of State.

4. Licensure and Certification Requirements

Kansas does not issue a distinct "Transitional Assistance Services License." Instead, providers operate under their existing business structure (often as a Home Health Agency, Area Agency on Aging, Center for Independent Living, or general vendor).

Providers must meet KDADS HCBS provider qualifications, which are verified during the KMAP enrollment process rather than through a separate facility licensure inspection.

• Facility Licensure: no specific state license exists solely for TAS provision.
• Home Health Agency License: required only if the provider is also delivering skilled nursing or personal care services alongside TAS.
• KDADS HCBS Certification: achieved through the KMAP enrollment process by selecting the appropriate HCBS provider type and specialty.
• Local Business License: required based on the city or county where the provider's administrative office is located.

5. Medicaid Provider Enrollment

Enrollment is processed through the KMAP Provider Portal. Providers must complete the base application and the HCBS addendum to be recognized by the state.

Once KMAP issues a provider ID, the agency must separately apply to the KanCare MCOs for credentialing.

• Enrollment Portal: applications are submitted via the KMAP Provider Portal (https://portal.kmap-state-ks.us/ProviderEnrollment/EnrollmentCreate).
• Provider Type: applicants typically enroll under Provider Type 55 (HCBS) or 08 (Home Health Agency).
• Application Fee: subject to the CMS institutional provider application fee unless enrolled as an individual or waived via Medicare enrollment.
• Required Forms: must submit the KMAP Provider Agreement and Ownership/Controlling Interest disclosure.

6. Staffing, Training and Background Checks

Staff coordinating TAS must pass comprehensive background checks to ensure the safety of vulnerable adults transitioning into the community.

Agencies must maintain proof of these clearances in their personnel files for state or MCO auditing.

• KBI Background Check: mandatory criminal history screening through the Kansas Bureau of Investigation for all staff interacting with KanCare members.
• KDADS Abuse, Neglect, and Exploitation Registry: all staff must be cleared through the state registry prior to employment.
• OIG Exclusion List: monthly screening required to ensure staff are not excluded from federal healthcare programs.
• Age Requirement: staff coordinating services must be at least 18 years of age.

7. Documentation, Policies and Records

TAS providers must maintain strict financial records since this service reimburses actual expenses. Receipts are mandatory for every item purchased.

Failure to maintain original receipts will result in immediate recoupment of funds during an MCO or KDADS audit.

• Expense Receipts: original, itemized receipts for all purchased goods and deposits must be retained in the member's file.
• Service Plan Alignment: documentation must match the authorized items listed in the member's Person-Centered Service Plan (PCSP).
• Record Retention: all financial and service records must be kept for a minimum of five years per KMAP policy.
• Member Signatures: delivery of goods requires a signed receipt from the member or their designated representative.

8. Billing, Rates and Claims

TAS is billed using specific HCPCS codes and is reimbursed based on actual costs up to the authorized limit, rather than a flat fee-for-service rate.

Claims must be submitted directly to the authorizing KanCare MCO, not to the state KMAP system.

• Procedure Code: typically billed using T2038 (Community Transition, waiver).
• Reimbursement Methodology: paid at actual cost based on submitted receipts, not to exceed the MCO's prior authorized amount.
• Prior Authorization: mandatory for all TAS expenditures; claims submitted without an MCO prior authorization will be denied.
• Claim Submission: claims are submitted directly to the member's KanCare MCO (Aetna, Sunflower, or UHC).

9. Approval Sequence and Timeline

The approval process is sequential. A provider cannot approach an MCO until the state KMAP enrollment is fully approved.

The entire process from business registration to billing the first claim typically takes four to six months.

• Step 1: Register business with the Kansas Secretary of State (1-2 weeks).
• Step 2: Submit KMAP provider enrollment application via the portal (30-60 days for processing).
• Step 3: Apply for credentialing with KanCare MCOs (90-120 days per MCO).
• Step 4: Execute MCO network contracts and load rates into the MCO claims system (30-45 days).

10. Common Denials and Survey Findings

Most audit findings and claim denials in TAS stem from purchasing unauthorized items or failing to secure prior authorization before spending funds.

Providers must strictly adhere to the approved PCSP and wait for the official MCO authorization number.

• Lack of Prior Authorization: purchasing items before the MCO officially approves the PCSP and issues an authorization number.
• Unallowable Expenses: submitting claims for prohibited items like televisions, cable setup, or monthly rent.
• Missing Receipts: failing to provide itemized store receipts to justify the billed amount.
• Exceeding Caps: billing for amounts that push the member over their lifetime TAS limit.

11. Key Contacts and Resources

Providers should rely on the official KMAP portal for state enrollment and the individual KanCare MCO portals for credentialing and billing guidelines.

KDADS publishes the official HCBS waiver manuals detailing TAS limitations.

• KMAP Provider Portal: enrollment and fee-for-service billing (https://portal.kmap-state-ks.us).
• KDADS HCBS Programs: waiver manuals and policy updates (https://kdads.ks.gov/services-programs/long-term-services-supports/home-and-community-based-services-hcbs-programs).
• Aetna Better Health of Kansas Provider Network: credentialing and MCO resources (https://www.aetnabetterhealth.com/kansas/providers).
• Sunflower Health Plan Provider Network: credentialing and MCO resources (https://www.sunflowerhealthplan.com/providers).

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