39-708a. Payment of claims to medical vendors not filed within fiscal year; limitation.

329 words·~1 min read·/ks/chapter-39/39-708a

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(a)Except as otherwise provided in subsection (b), the director of accounts and reports shall accept for payment from an agent or intermediary authorized to make medical payment reviews and to determine the amount due to medical vendors for the care of needy persons, in accordance with agreements entered into by the secretary under the provisions of subsections

(s)and

(x)of K.S.A. 39-708c , and amendments thereto, notwithstanding the fact that such claims were not submitted or processed for payment within the fiscal year in which the service was rendered.

(b)No claim filed more than 12 months after the time the service was rendered shall be allowed or paid except that payment to medical vendors may be made on claims submitted more than 12 months after the service was rendered:

(1)If the services were provided to a child who at the time of service was in the custody of the secretary, or a child for whom the agency has entered into an adoptive support agreement if the medical vendor did not have actual knowledge of that fact prior to the expiration of the 12-month period;

(2)if the claim was submitted to medicare within 12 months of the date of service, paid or denied for payment by medicare, and subsequently submitted for payment to the state medical assistance program within 30 days of the medicare payment or denial date;

(3)if the claim is determined payable by reason of administrative appeals, court action or agency error;

(4)if the claim is for emergency services rendered by providers located outside the state who are not already enrolled as state medical assistance program providers; or

(5)if the claim arises out of circumstances described under items (1), (2),

(3)or

(4)and is determined not to be payable under any such item, but the secretary determines that such claim is the result of extraordinary circumstances.