Welcome, providers! As you know, the Kansas Medicaid program is going through significant changes. Effective January 1, 2013, the Medicaid program moved from a fee-for-service program model to a managed care program model. The following health plans or managed care organizations (MCOs) were awarded the contracts to provide KanCare services: Amerigroup, Sunflower and UnitedHealthcare.
Things to Know
- If you wish to continue serving Kansas Medicaid consumers, you must sign up with at least one of the KanCare plans. Medicaid consumers were assigned evenly across all three health plans, so to ensure you can continue to see all of your Medicaid patients, you should sign up with all three.
- The KanCare health plans must pay at least 100 percent of the current fee-for-service Medicaid rate (as of 11/9/12) to all contracted, in-plan providers. The rate cannot decrease for the life of the KanCare contracts. You can negotiate a different reimbursement structure if you would like to do so.
- If you do not sign up with the KanCare health plans, you will be considered an out of network provider. Out of network providers will receive 90 percent of the current fee-for-service rates.
To ensure a broad base of providers, we encourage that you as providers enroll with each of the KanCare plans. To help make that transition easier, an application for facilities, hospitals, and HCBS providers and an application for behavioral health providers has been developed which all of the plans will be using. These standardized applications can be found at each of the health plans’ web sites or below. The applications will be used for waiver services, long term care facilities, behavioral health providers, and hospitals. For any clinicians who wish to enroll, this process can be done through the CAQH credentialing process.
If you do choose to participate in all three KanCare plans please fill the initial application out and make copies to submit to the other two plans. It is very important that the signature page is an original for all three application sets.
You can find more information about each of the KanCare plans at their websites below, or go to the KanCare Health Plan Information page.