Debarment and Suspension
Required Elements of Service System Development and Coordination
In case of a dispute regarding whether a service is medical, mental health or substance abuse, SRS will serve as the final decision maker, first using the list of covered and required services and then considering the service codes that were used as the basis for the development of the original capitation payment.
For youth who are receiving substance abuse treatment services, some similar services are available through other funding streams such as the child welfare or juvenile justice systems. ValueOptions of Kansas, the youth’s case manager(s), the youth’s natural, foster, or adoptive parents as appropriate and legally allowable, and others involved in providing services to the youth are required to plan jointly for both the delivery and funding of services appropriate to the needs of the youth. In case of a dispute regarding whether a service is the appropriate funding responsibility of ValueOptions, child welfare or juvenile justice systems, SRS will serve as the final arbiter, based on the following:
- whether the service is directed towards achieving youth safety and permanency or community safety, or whether the service is directed towards addressing the youth’s substance abuse treatment;
- considering the list of covered and required services; and
- considering the service codes that were used as the basis for the development of the original capitation payment.
Transportation for T-XIX Members to medically necessary substance abuse treatment appointments is the responsibility of HealthWave XIX (for Members enrolled in managed care) or the KHPA (for fee-for-service). ValueOptions is responsible for coordination with HealthWave XIX or KHPA for T-XIX Members.