KY Medicaid COVID-19 Information

The information on this page is specific to Medicaid beneficiaries and providers. For more information about COVID-19, refer to the state COVID-19 website.

During the COVID-19 state of emergency, individuals younger than 65 without medical insurance should complete the Healthcare Coverage Application to request temporary coverage under Kentucky Medicaid presumptive eligibility. By completing this application you attest that you do not have medical insurance that covers doctors, pharmacy or hospital visits. To maintain Medicaid benefits beyond the presumptive eligibility coverage period, complete a full Medicaid application online at Kynect, call (855) 306-8959 or contact a local kynector for application assistance.

Effective Jan. 1, 2021, presumptive eligibility Medicaid members will be enrolled in managed care with UnitedHealthcare Community Plan of Kentucky (UHC) and will receive a UHC member ID card and handbook. Direct questions about UHC healthcare coverage to Member Services at (866) 293-1796 or visit the UHC website. UHC call center is staffed Monday - Friday, 7 a.m. - 7 p.m. Eastern time. Hours will be extended Saturday, Jan. 2 from 8 a.m. - 4:30 p.m. and Sunday Jan. 3 from 9 a.m.-4 p.m.

Provider General Information

Provider Letter #A-107: COVID-19 Presumptive Eligibility
Provider Letter A-105: COVID-19 Guidance for all Medicaid providers
KY Draft 1135 Flexibilities Approval Letter
Families First Coronavirus Response Act - increased FMAP FAQ
NADSP Onboardng DSPs during COVID-19 Crisis
Social Security Administration: Significant changes to operations and policies

CMS COVID-19 News

COVID-19 Medicaid and CHIP Service Utilization Data Snapshot

(Jan. 18, 2021) The Centers for Medicare and Medicaid Services released a Medicaid and Children's Health Insurance Program (CHIP) COVID-19 snapshot of data from the beginning of the public health emergency through July 31, 2020.

This snapshot provides a variety of information on COVID-19-related service used by beneficiaries. Specifically, the snapshot includes data for the period on testing, treatment and outcomes; service use among Medicaid and CHIP beneficiaries 18 and younger; services delivered via telehealth; and services for mental health and substance use disorders

Please review the Data Snapshot

HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid and CHIP Providers

CMS has issued answers to frequently asked questions regarding patient presentation to the emergency department, Emergency Medical Treatment and Labor Act applicability across facility types, qualified medical professionals, medical screening exams, patient transfer and stabilization, telehealth and other topics.

Long-term care facilities news and updates

CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19
Updated cases and response activities
Requesting PPE Fact Sheet
LTC Admissions and Transfers Guidance
Kentucky Nurse Aide COVID-19 Information and Procedures

Kentucky Level-of-Care System (KLOCS) Go-Live and Training

The new planned go-live for the KLOCS is Aug. 3, 2020 LTC, ICF/IDD facilities and hospice providers are required to use KLOCS starting Aug. 3 to receive payment. Beginning July 20, DMS will offer a free two-part Zoom webinar on KLOCS system functionality. Staff who handles LOC applications is encouraged to participate. Registration information will be provided in the coming weeks. Thank you for your understanding and continued commitment to keeping your communities and residents safe.

Nursing Facilities and Nurse Aide Training Providers

Medicaid temporarily has waived the mandatory 16 hours of supervised clinical instruction prior to testing and the skills demonstration portion of the final exam until further notice. Upon employment, the mandatory 16 hours of supervised clinical instruction must be completed within the first 30 days of employment. The Department for Medicaid has increased the testing window 30 days allowing 150 days from date of employment to be listed on the registry. The department will monitor and update these waivers as needed during this health emergency.

HCBS Waiver Information

Approved Appendix K for 1915(c) HCBS Waivers

COVID-19 FAQ for 1915(c) HCBS Waivers
Provider Letter: COVID-19 Holiday Guidance for Residential Providers
Provider Letter A-106: COVID-19 and Telehealth for Behavioral Health Providers
Provider Letter: COVID-19 Guidance for 1915(c) HCBS waiver providers
Provider Letter: COVID-19 and Telehealth for 1915(c) HCBS waiver providers
Provider Letter: COVID-19 and Waiver Provider Certification and Monitoring
Provider Letter: COVID-19 ABI and MPW Assessments
Provider Letter: COVID-19 and Model II Assessments
Provider Letter: Reporting COVID-19 Cases for 1915(c) HCBS Waivers
Provider Letter: ADHC and ADT Temporary Closure Information

What’s New

Cost Report Update

(Jan. 14, 2021) Based on communication from the Medicare audit contractors to providers, CMS has authorized the delay of certain Medicare cost reports. As a result, DMS also will grant any cost report extensions granted by Medicare. At this time, it appears the following fiscal year end cost report extensions have been granted:

Fiscal Year End	Initial Due Date	Revised Due Date
June 30. 2020	Nov. 30, 2020	Jan. 31, 2021
July 11, 2020	Dec. 21, 2020	Feb. 28, 2021
Aug. 31, 2020	Jan. 31, 2021	March 31, 2021
Sept. 30, 2020	Feb. 28, 2021	April 30, 2021
Oct. 31, 2020	March 31, 2021	May 31, 2021
Nov. 30, 2020	April 30, 2021	June 30, 2021
Dec. 31, 2020	May 31, 2021	July 31, 2021

Please call (502) 564-8196 if you have any questions and ask for the staff referenced below based on provider type.

Provider Type	DMS Contact
Home Health	Tara Brewer
Hospital	Barb McCarter
Nursing Facility	Lynette Gurney

COVID 19 Vaccine Provider Letter

(Dec. 30, 2020) - All Kentucky Department for Medicaid Services providers seeking to receive and administer the COVID-19 vaccine must enroll with the Kentucky Department for Public Health (KDPH) as soon as possible at vaccine provider enrollment.

A vaccine provider enrollment checklist is provided with instructions for enrollment. After reviewing the information, direct questions related to vaccine provider enrollment to KDPH.

Read the:

U.S. Dept. of Health and Human Services Provider Relief Fund Eligibility and Updated Reporting Requirements

(Oct. 22, 2020) The U.S. Department of Health and Human Services announced the latest Provider Relief Fund (PRF) application period has been expanded to include more provider applicants who have not yet received PRF distributions. These providers and all phase 3 applicants have until 11:59 p.m. Eastern time, Nov. 6, 2020 to submit applications for payment consideration.

The list below includes eligible providers and practices that now may apply for phase 3 funding regardless of whether they accept Medicaid or Medicare.

Eligible Practices and Types of Providers

Allopathic and osteopathic physicians
Allopathic and osteopathic physicians
Ambulatory health care facilities
Assisted living facilities
Behavioral health providers
Behavioral health providers
Chiropractors
Dental providers
Dental providers
Emergency medical service providers
Eye and vision services providers
Hospice providers
Hospital units
Laboratories
Nursing service and related providers
Nursing and custodial care facilities
Physician assistants and advanced practice nursing providers
Podiatric medicine and surgery service providers
Residential treatment facilities
Respiratory, developmental, rehabilitative and restorative service providers

Updated Reporting Requirements

HHS has amended reporting instructions for the use of PRF money to recoup lost revenue due to coronavirus. After reimbursing healthcare-related expenses due to coronavirus not reimbursed by other sources, providers may use remaining PRF funds to cover lost revenue measured as a negative change in year-over-year actual revenue from patient care related sources.

Links to Information

Read the Press Release
Read the policy memorandum on the reporting requirement decision
Read the amended reporting requirements guidance
Learn more about the Provider Relief Program,

New Long-Term Care Resource

(Oct. 15, 2020) CHFS Office of Inspector General Long -Term Care COVID -19 Resources

COVID-19 Flow Chart for testing coverage for Nursing Facility Residents.

(Sept. 22, 2020) - The Center for Medicare and Medicaid Services released information to help states, nursing facilities and other providers better understand the sources of Medicare and Medicaid coverage and payment for COVID-19 testing, including a flow chart detailing testing coverage for nursing facility residents. We encourage you to view the Coverage and Payment for COVID-19 Testing in Nursing Facilities Flow Chart,

Medicaid COVID-19 FAQ

Re-Opening Adult Day Health Center
Re-Opening Adult Day Training
Phased restoration of group activities, communal dining, off-site appointments and visitation

Member Information

August is Immunization Awareness Month

Please make sure your children are up to date on their shots. Immunizations help prevent diseases like hepatitis B, polio and measles, mumps and rubella (MMR or MMRV vaccine). Schedule an appointment with a doctor now to ensure your children are protected. Please see the following awareness materials:

If you are a Medicaid member, visit the Department for Public Health immunization page for more information. If you are a Medicaid provider and would like to participate in the Vaccines for Children Program visit the program website.

Vaccine recommendations during COVID-19 outbreak

Applying for Medicaid

Individuals may apply for Medicaid only by calling the Kentucky Healthcare Customer Service line toll-free at (855) 459-6328 or contacting an application assister through the Kentucky Health Benefit Exchange website.

Apply for all public assistance programs by visiting the kynect website or by calling the DCBS Call Center toll free at (855) 306-8959.

Additional Information

SAMHSA OTP Guidance
SAMHSA issued guidance allowing states with and without emergency declarations to allow opioid treatment programs to provide 28 days of take-home medication to stable patients and 15 days of medication to less stable patients the OTP believes
SAMHSA 42 CFR Part 2 Guidance
SAMHSA issued guidance which allows providers to share patient SUD diagnosis information normally protected under 42 CFR Part 2 in instances of a bona fide medical emergency. The use of the medical emergency exception must be documented by providers.
CMS Guidance on Postponing Elective Surgery
CMS issued guidance to stakeholders advising limits on all non-essential planned surgeries and procedures, including dental procedures. The guidance provides a triaging method to assist with decisions in this area.
CMS Guidance to Catastrophic Coverage Plans
CMS issued an FAQ clarifying that catastrophic coverage plans must include coverage of COVID-19 diagnosis and treatment under the essential health benefits. CMS will waive enforcement actions against any such plan which provides COVID-19 services before patients pay the plan deductible and encourage plans and states to provide such pre-deductible coverage.