The QA system was established to improve program management by providing management information related to payment accuracy and to satisfy federal requirements. The Medicaid Eligibility Quality Control (ME QC) unit within KDHE serves as the designated entity for federal ME QC compliance and is responsible for coordinating and conducting all required federal reviews. Local agency staff are required to cooperate with ME QC in conducting reviews. Cooperation includes, but is not limited to:
Each entity with responsibility for eligibility determination shall also have a local quality assurance process in place. This will include period case reviews, evaluation and corrective action as necessary.
Reserved
Care needs to be taken to make requests of other agencies only when necessary. In making inquiries in other states, consult the latest edition of "The Public Human Services Directory" for information regarding the agency and whether the state agency acts as a forwarding center. Inquiries should be addressed to the agency concerned whether inside or outside of the state, unless the staff considers this a particular problem which needs to be routed through Program Administration.
A signed copy of the Information Release Form should be included in the correspondence whenever the consent of the client to the giving of that information is needed. This would include information such as medical, legal, or financial.
Out-of-town inquiries should be answered promptly and in sufficient detail to enable the inquiring agency to plan effectively. The local manager or supervisor must read and sign all correspondence when agency policy rather than individual case planning is involved.