MedicaidPrior AuthMedium impact
KMAP BULLETIN: MCOs Retroactive Eligibility Procedures
Kansas Medicaid (KanCare)·KS·Provider Bulletin
We identified it
Jun 21, 2026
Summary
Kansas Medicaid managed care organizations (Sunflower State Health Plan, UnitedHealthcare Community Plan, and Healthy Blue) have streamlined procedures for retroactive eligibility authorization and claims processing. Providers can now request prior authorization after services are provided for retro-eligible members, and should indicate the retroactive eligibility status when submitting authorization requests.
Action Required
Immediately: Update authorization request procedures to indicate when requesting authorization for retroactively eligible Medicaid members. Submit authorization requests after services are provided but before claim submission. For denied claims due to lack of authorization, utilize each MCO's established review process. Train staff on the new streamlined process for Sunflower State Health Plan, UnitedHealthcare Community Plan, and Healthy Blue retroactive eligibility cases.