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Kansas Medical Assistance Program · November 5, 2026 · Primary source

KanCare 3.0 Open Claims Resolution Log

Score 59PRIMARYregulatoryState MedicaidKS

Summary

The Kansas KanCare 3.0 Open Claims Resolution Log, revised November 5, 2026, catalogs active billing and payment errors under the Kansas Medicaid managed care program that remain under investigation or in reprocessing. Open issues include hospice claims processing errors (missing modifiers, claims paid without member hospice election, and incorrect manual overpayments), coordination of benefits logic failures by Healthy Blue when Medicaid is secondary, Electronic Visit Verification rate reversions to state standard rates following an AuthentiCare system release, and ongoing nursing facility and mental health facility rate adjustments. MCO reprocessing timelines extend through late 2026 for several items.

What this may mean

Hospice providers in Kansas face recovery letters from Sunflower Health Plan for claims paid without required modifiers or proper hospice election documentation, with recovery completion estimated by November 16, 2026. Hospitals and other providers have open overpayment and underpayment exposure across multiple MCOs pending systematic reprocessing. EVV-dependent home- and community-based service providers billing Healthy Blue may have claims paid at incorrect state standard rates rather than negotiated rates, with Healthy Blue reprocessing still pending.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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