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Unbridled Spirit

Reporting Health Care Fraud

DMS works in conjunction with the Office of the Inspector General (OIG) to combat fraud and abuse. If you suspect Medicaid fraud, report it.

Contact Information

For questions or assistance, send an e-mail to the CHFS DMS Webmaster

For KyHealth-net assistance, contact the EDI Helpdesk at (800) 205-4696.

Department for Medicaid Services

Press Release: Enhanced Community Services Will Begin in August

Thursday July 24

The Cabinet for Health and Family Services (CHFS) and Kentucky Protection and Advocacy (P&A) have reached a compromise that will allow individuals with mental retardation or other developmental disabilities to begin the process to receive enhanced community services in August, under an amended settlement agreement for the Michelle P. class action lawsuit.  Click here to read the July 14, 2008 News Release.

For more information about the Michelle P Waiver, refer to the new Michelle P Waiver website.

Announcement:  Provider Notification

Thursday June 26

Effective April 1, 2008, the Cabinet for Health and Family Services(CHFS) Department for Medicaid Services (DMS), has selected Health Care Excel (HCE) as the Medicaid Surveillance and Utilization Review System (SURS) contractor. Starting July 1, 2008, HCE will be conducting retrospective audits of Medicaid providers' paid claims.

For more information. click on the Provider Notification.

Announcement:  Provider Notification

Providers who are continuing to submit the NPI and legacy on claims, are strongly encouraged to begin billing the NPI only in order to avoid payment delays once Kentucky Medicaid begins rejecting claims containing a legacy provider ID.  At some point in the near future, Kentucky Medicaid will deny claims containing a legacy number along with the NPI.

If you have further questions, contact the EDI Helpdesk at (800) 205-4696.

Got Questions? Need More Information?

Still not sure what an NPI is and how you can get it, share it? Click to view the Frequently Asked questions regarding NPI registration.  Providers may also contact First Health at (800) 639-5195.

Still not sure how to submit claims with your NPI? Click to view the Frequently Asked Questions regarding filing a claim with the NPI.  Providers may also refer to the Provider Billing Instructions or contact Provider Relations at (800) 807-1232 or the EDI helpdesk at (800) 205-4696

Announcement - Policy Clarification for Tamper Resistant Prescription Pads (TRPP)

Tuesday April 8

The April 1, 2008 implementation of the tamper-resistant prescription pad requirements for written prescriptions billed to Medicaid has been successful thus far.  However, there are policy clarifications that seem appropriate based on the questions received. To view the clarifications, click the Policy Clarification for Tamper Resistant Prescription Pads.

Announcement - Tamper-resistant Prescription Pads Requirements effective April 1

Friday, March 21

Effective April 1, Medicaid will require all written prescriptions for outpatient drugs, including over-the-counter drugs, to be on tamper-resistant prescription pads.  As you may recall, Congress mandated the new requirement last year, but temporarily postponed implementation until April 1 to allow more time for states to respond.

For more information about the tamper-resistant pads, click on the General Provider Letter #A-80 - Tamper-resistant Prescription Pads Requirements Effective April 01, 2008.

 
Mission, Vision and Values
 

Mission Statement

Owing to the unbridled spirit of our workforce, the mission of Kentucky Medicaid is to provide innovative opportunities to our members that will promote healthy lifestyles, personal accountability and responsible program governance for a healthier Kentucky.

Vision

To serve as a national model for achieving excellence in Medicaid by increasing the quality of benefit services, transforming care management, updating relevant technology, providing support for an outstanding workforce and preventing, detecting and reducing waste, fraud and abuse.

Values

The Department for Medicaid Services values respect for all persons with whom we come in contact; integrity in all our transactions and dealings with one another and the public; competency in each task we perform; collaboration in making decisions that impact others; accountability for our decisions and actions; excellence in all we endeavor to achieve; and commitment to one another, our members and our providers.

 

Last Updated 8/5/2008
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