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KMAP BULLETIN: Process Improvements for the KCPC System Manual Workaround

Date: 04/12/19

KMAP GENERAL BULLETIN 19061 (PDF)

The Kansas Department for Aging and Disability Services (KDADS) is in the process of procuring a new Substance Use Disorder (SUD) data system to replace the current Kansas Client Placement Criteria (KCPC) system. In the interim, SUD providers and contractors, KanCare managed care organizations (MCOs) and the Administrative System Organization (ASO) for the Block Grant, have been using different manual workaround forms and processes. The contractors are also using different prior authorization criteria.

At the request of providers and to streamline the process and make it more consistent, the contractors were asked by the State to collaborate and develop one common eligibility form for Block Grant members and member service authorizations (Block Grant and Medicaid). This process also ended the requirement for prior authorizations on SUD lower levels of care.

The Process Improvements for the KCPC System Manual Workaround policy is effective April 15, 2019. The policy with the SUD Services Request form and instruction sheet can be found on the KDADS website in the “Policies Related to Managed Care Organizations and Block Grant” section.

For questions regarding the SUD Services Request Form or Instructions, contact the applicable MCO:

  • Aetna Better Health of Kansas – Kristin Gernon: GernonK@aetna.com or 785-596-8498
  • Sunflower Health Plan – Behavioral Health Utilization Management Department: 1-877-644-4623
  • UnitedHealthcare Community Plan of Kansas – Sandra Berg: Sandra.berg@uhc.com or 913-333-4067

For all policy-related questions, contact Cissy McKinzie at tamberly.mckinzie@ks.gov