Kan. Admin. Regs. § 129-9-3 - MCE provider grievance

(a) Any provider rendering services to an enrollee may submit a grievance about any MCE matter other than an action.

(b) Any provider may submit an oral or written grievance to the MCE within 180 days of the date of the incident. Any provider may submit a grievance in person, by telephone, by U.S. mail, or by facsimile. Each written grievance delivered by the postal service or submitted by facsimile to the MCE shall be date-stamped when received by the MCE as proof of receipt. The date of receipt shall be used to determine the timeliness of the request.

(c) The MCE shall resolve each grievance within 30 days from the date the MCE receives the grievance from the provider and provide notice of grievance resolution no later than five business days following the date of grievance resolution as specified in the state's managed care contract. The notice of grievance resolution shall meet the requirements specified by the secretary.

(d) The provider's right to request a grievance shall not be limited or interfered with by the secretary or the MCE.

(e) The MCE shall cooperate with the state, the state's fiscal agent, or representatives of either to resolve all grievances. Cooperation may include providing internal provider grievance information to the state.

Notes

Kan. Admin. Regs. § 129-9-3

Authorized by and implementing K.S.A. 65-1,254 and 75-7403; adopted by Kansas Register Volume 43, No. 50; effective 12/27/2024.