KMAP BULLETIN: Hospice Recertification Documentation
Date: 09/15/23
KMAP GENERAL BULLETIN 23238 (PDF)
Effective with dates of service on and after October 1, 2023, hospice providers must submit documentation to KanCare Managed Care Organizations (MCOs) upon request of a face-toface encounter with hospice recipients in accordance with Code of Federal Regulations 42 CFR 418.22.
Members with lengths of stay approaching the third episode of care and thereafter are subject to documentation review to support the continued need for hospice care. In the event of a post-pay review, claims for services that lack clinical justification for continuation of services are subject to recoupment.
Access to Records
Kansas Regulation K.A.R. 30-5-59 requires providers to maintain and furnish records to the Kansas Medical Assistance Program (KMAP) upon request. The provider agrees to furnish records, original radiographs, and other diagnostic images, which may be requested during routine reviews of services rendered and payments claimed for KMAP consumers. If the required records are retained on machine-readable media, a hard copy of the records must be made available.
The provider agrees to provide the same forms of access to records to the Medicaid Fraud and Abuse Division of the Kansas Attorney General’s Office upon request from such office as required by K.S.A. 21-3853 and amendments thereto.
Note: The effective date of the policy is October 1, 2023. The implementation of State policy by the KanCare MCOs may vary from the date noted in the 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.