2692 Mandated TB Care

Individuals diagnosed as tubercular and are found in need of treatment for this condition by the Tuberculosis Control and Prevention staff at the Kansas Department of Health and Environment (KDHE) are eligible for limited medical assistance coverage. Coverage is limited to inpatient hospital care or necessary alternative community-based care as approved KDHE. Only those services deemed necessary on the care plan developed by KDHE and approved by KDHE-DHCF policy staff are covered. KDHE and local health department staff are responsible for ensuring the care plan is cost effective. No other services or items, such as prescription and physician services are covered.

Eligibility is solely based on a TB diagnosis and an approved care plan from KDHE. No further eligibility requirements must be met including financial, SSN and citizenship/alienage. TB-Only coverage may be approved presumptively while being screened for Medicaid coverage. If eligible for full coverage Medicaid, persons must enroll in Medicaid. Persons receiving Medically Needy coverage may receive TB coverage in addition to Medically Needy. See 1411.3 (3) for application process. TB-Only coverage shall not be affected by a denial of Medicaid eligibility for any reason and shall only be discontinued if approved for Medicaid coverage or once determined appropriate by KDHE TB Program staff.

Medical coverage shall be authorized for the period approved by KDHE only. If coverage is authorized for a period exceeding 6 months, a new application is not necessary but the continued need for coverage must be confirmed with KDHE TB program staff.

All applications for TB coverage are processed by the TB Eligibility staff at the KanCare Clearinghouse. Persons requesting coverage are referred to KDHE.

FFP is not available for any services provided under the TB only program. A monthly medical card will be issued to each participant, but coverage is limited as explained above.