New KDADS policy posted for public comment.
· Conflict of Interest Policy - Comments due by 8/26/16Policy Description: Conflict of Interest Policy
Additional Form: Designated Representative Form
Policy Number: N/A
Date Posted: 07/26/16
Comments Due: 08/26/16
Comments To: KDADS.HCBS-KS@KS.GOV
Policy Status: Draft
This policy is established for the purpose of compliance with the Centers for Medicare and Medicaid Services (CMS) conflict of interest requirements. It is intended to mitigate conflict of interest that may exist where home and community based Medicaid services are provided. Participants can maintain control of services and conflicts of interest may be mitigated by securing a Durable Power of Attorney (DPOA) or separating the “employer of record” from the “manager/worker” and the use of administrative firewalls to separate the two entities by appointing a designated representative to perform to direct the participant’s HCBS services.
“Targeted” case management services are those aimed specifically at special groups of individuals, such as those with Intellectual/developmental disabilities or chronic mental illness.
Case management services are comprehensive and must include the following (42 CFR 440.169(d)):
According to the Centers for Medicare and Medicaid Services (CMS), case management services must be “conflict free” meaning there is a separation of duties from coercion.
"Targeted Case Management assists the person and support network to identify, develop, select, obtain, coordinate, utilize and monitor paid services and natural supports to enhance the person’s independence, integration, productivity and community inclusion consistent with the person’s needs and life style preferences as outlined in the person-centered support plan."
We ensure that the individuals we serve have access to needed medical, social, educational and other community services available to them according to their wishes as outlined in the Person=Centered Support Plan.
Individuals who receive KanCare and who are qualified for Title 19 are eligible for Targeted Case Management. If you are unsure about your Kancare/Medicaid, call your local CDDO to ask if you qualify for Targeted Case Management services. To access a list of Case Management Service Providers in Johnson County, Click Here!
Your Medical Care Coordinator is NOT your Targeted Case Manager. Targeted Case Management is a service available and protected by Kansas State Article 63. Your Medical Care Coordinator (sometimes inaccurately referred to as case manager) monitors services available (or funded) to you through your Medicaid/Kancare provider. View a handout from Kansas Department for Aging and Disability Services to help understand the difference between targeted case management and care coordination.