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OneCare Kansas & Targeted Case Management Services

Date: 05/20/21

A Message for Target Case Management (TCM) providers.

Please share with those in your organization who may have members in the OneCare Kansas (OCK) program.

We are sharing information regarding Targeted Case Management (TCM) services when a member chooses to enroll in OneCare Kansas.

The Kansas Department of Health and Environment (KDHE) OneCare Kansas Brochure for members now includes the following clarification:

  • Will this change the people you work with now? There is an exception with targeted case management.

The state plan for OneCare Kansas was effective April 1, 2020, and includes the following clarification: TCM services and reimbursement will not be duplicated with OCK services.

  • The state plan reflects federal rules that do not allow members to receive both TCM services and OCK services at the same time.
  • A KanCare member has the choice to enroll in OneCare Kansas. TCM services cannot be reimbursed and should not be provided while the member is receiving OneCare Kansas services.

A provider can view the status of a member's enrollment in OneCare Kansas by completing an eligibility verification:

  • On the Sunflower Provider Portal. When you look up a member, the overview screen will display their OneCare Kansas status.
  • On KMAP. Under MCO assignment, it will reflect Health Home Assignment, “This member is a Health Home Participant.”

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative: