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KMAP BULLETIN: Hospital Service Payment Increase

Date: 08/07/18


Effective August 24, 2018, and retroactive to dates of service on and after July 1, 2018, a reimbursement policy change will be implemented so all inpatient and outpatient hospital service payments issued by the Kansas Medical Assistance Program (KMAP) will be increased by 4% per House Substitute for Senate Bill 109. The increase will apply to the current base fee schedule located on the KMAP website.

The 4% increase will be applied to the outpatient fee schedule base rate and will be applied separately from the HCAIP adjustment factor.

The inpatient diagnostic related group (DRG) base rates will increase by 4% and the outliers will not be adjusted. The 2016 HCAIP inpatient reduction will continue to be applied to the claim.

The following provider type/specialties will receive the 4% increase. State institutions are excluded from this increase.

  • 01/010 – Hospital; Acute Care
  • 01/011 – Hospital; Psychiatric
  • 01/012 – Hospital; Rehabilitation
  • 01/017 – Hospital; Tuberculosis
  • 01/400 – Hospital; Screening Brief Intervention Referral Treatment (SBIRT)

Note: The effective date of the policy is July 1, 2018. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.