Ambulance services reimbursement changes
In accordance with 42 CFR 447.205, the Kentucky Department for Medicaid Services provides public notice of changes to ambulance services reimbursement language in its state plan effective Jan. 1, 2022. The state plan language change aligns with KRS 205.5601-5603 reflecting the methodology for increasing Medicaid reimbursement for ground ambulance services.
Review the public notice
Mandatory Medicaid state plan coverage of medication-assisted treatment
The Kentucky Department for Medicaid Services issued a public notice of updates to the state plan related to medication-assisted treatment for individuals with opioid use disorder. Review the public notice
Ambulance supplemental payment program
The Kentucky Department for Medicaid Services has issued public notice of changes to the ambulance services reimbursement language in its State Plan effective July 1, 2021.
Review the entire public notice
Public Notice page to see all public notices.
Baby Formula Shortage Resources
Resources are available for Medicaid members affected by the baby formula shortage. The Department for Public Health has published a guide to local and national resources to help Kentuckians find formula.
Behavioral Health Code List Now Available
A list of behavioral health codes that are reimbursable by Kentucky Medicaid is now available.
Work continues on Kentucky Mobile Crisis Intervention Planning Grant project
Kentucky continues its work on a grant to expand and strengthen services for individuals experiencing behavioral health crises. Currently, a thorough review is underway of the availability and delivery of mobile crisis services in Kentucky. Review the KY mobile crisis intervention needs assessment or visit the Behavioral health initiatives page for more information.
DMS begins work on Kentucky Mobile Crisis Intervention Planning Grant Project
Kentucky has received a grant to expand and strengthen services for individuals experiencing behavioral health crises. Review the
MCI grant announcement for information on the grant and how to get involved.
Providers wanted for the Programs of All-inclusive Care for the Elderly (PACE)
DMS will begin coverage for PACE providers in 2022. DMS has enrolled several providers but more are needed. Please review the
list of enrolled PACE providers, the
list of counties in need of PACE providers and the
PACE provider FAQ for more information. Interested providers should
email Justin Dearinger.
Under the current KY HEALTH SUD 1115 Demonstration authority, the state is required to implement utilization management approaches to ensure an independent process for reviewing placement in residential treatment settings and interventions appropriate for the diagnosis and level of care.
The KY State Plan requires individuals to be assessed and meet dimensional admission criteria for approval of residential level-of-care placement in accordance with current ASAM treatment criteria for addictive, substance-related and co-occurring conditions.
Prior authorization will be reinstated effective July 1, 2022 for SUD residential and inpatient treatment services, including ASAM Levels 3.1, 3.5, 3.7 and 4.0.
Correcting Medicaid Member Incarceration Status Errors
Kentucky Medicaid has a new form providers can use to help members who are incorrectly listed as incarcerated in
KYHealthNet. Please review the
guidance for reporting incarceration errors and the new
MAP-INC form for more information.
Administrative Regulations Filed
Visit the DMS
Regulation page for recently filed regulations.
CMS health care quality core set chart packs
Each year the Centers for Medicare and Medicaid Services publishes core measures of the quality-of-care and health outcomes for adults participating in Medicaid and children enrolled in the Medicaid Children’s Health Insurance Program. Please view:
Cost Report Update
(July 14, 2020) The Centers for Medicare and Medicaid Services authorized the delay of some Medicare cost reports. The KY Department for Medicaid Services grants the same extension to providers who received an extension approval through CMS or the designated Medicare administrative contractor. Please call (502) 564-8196 if you have any questions and ask for the staff referenced below based on provider type.
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