Review Extension for April 2016 through October 2016 – January 31st
CHIP Premium Discontinuance Batch – February 7th
Spenddown Met to Unmet - February 10th
Buy-In Deletion Report available – February 17th
Review Batch Run – February 15th
Buy-In Deletion Report completed – February 17th
Timely Notice Closure – February 16th
Negative Change – February 16th
MMIS Monthly – February 20th
April Come-Up Month Available – February 19th
A special review extension process ran the evening 01/31/2017. It extended the review date/CE dates for Family Medical programs that had original review dates from 04/2016 through 10/2016. The following were impacted:
Family Medical program blocks with an expired Review Due Month, where the review had been returned but not yet processed. The Review and CE dates were extended one year from the original Review Due Month.
Family Medical program blocks with an expired Review Due Month and a determination was completed but the Review Due Month and Review/IR were not updated. The Review and CE dates were extended to match the earliest CE date on the program if it is later than the date determined in Item #1.
The process updated the review date, the CE date and the Review/IR record. Any Process Review task related to the review was voided. There were no notices generated. There is no EDBC run associated with this update either. A journal entry was created with the following text:
‘Per KDHE Directive, the Review Due month for this medical program block was extended through (Insert Date). CE dates for members included on this program block also extended to match the review period. No EDBC was run to complete this action however the Report Status for the review on the Review and IR/ 12 month Reporting List page was updated to "Complete-EDBC Accepted" to indicate that the review process was completed. Previous Process Review task has been void. Notice not required for this action.’
NOTE: Elderly and Disabled Program Blocks were not impacted.
The attached process replaces the ‘Processing Multiple e-Apps’ process that appeared in the 1/21/2016 KEES Dispatch. This new process will also be added to the KEES User Manual in the e-Applications folder.
An income change reported at the time of a request to add a new individual is processed in the month of report. The new income must be verified and updated in the system prior to processing the request for the new individual. This allows the new income to be used in the determination for the new person, and is also applicable to the rest of the household members. This could result in a change in coverage or the reduction or removal of a premium obligation in the month of report when applicable.
The impact on existing individuals will only occur in the month of report – even when there has been a request for prior medical and it is necessary to determine eligibility in prior months.
The attached process will allow eligibility to be processed for the new individual in Prior Med, while not allowing coverage or premium obligation to be updated for the current recipients until the month of the reported income change. This will need to be done with the use of Customer Options. See the attached process on how to achieve this.
Please refer to the Income Change with an Add a Person and a Prior Medical Request document for further details.
Updated versions of the IM-3121 Letter to Veteran’s Administration for Benefit Verification and the MS-2156 Medical Review of Emergency Services for establishing SOBRA Eligibility are now found on KFMAM under the Forms tab.
Call Center Phone Number: 844-723-5337
KEES Tier 1 (Access Issues Only)