House Joint Resolution 57 Workgroup meeting is Oct. 5, 2021 from 3 - 4:30 p.m. Eastern time via Zoom.
Join Zoom Meeting
Phone: (713) 353-0212 or (888) 822-7517
Conference Code: 599250
View House Joint Resolution 57
Mandatory Medicaid State Plan Coverage of Medication-Assisted Treatment
The Kentucky Department for Medicaid Services has 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 for more information.
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 for more information.
Public Notice page to see all public notices.
Open Enrollment for 2022 Begins
Open Enrollment runs from Oct. 15 - Dec. 1, 2021. View the Open Enrollment website for more information.
Providers Wanted for the Programs of All-Inclusive Care for the Elderly (PACE)
DMS will begin coverage for PACE providers in 2022. Please review the list of counties in need of PACE providers and the PACE provider FAQ for more information. Interested providers should email Justin Dearinger.
Prior Authorization Information - Update
DMS is removing prior authorization (PA) for inpatient and outpatient services provided by hospital providers, effective Aug. 13, 2021. Prior Authorization Guidance
PA will not be required for all covered behavioral health and SUD services until further notice. DMS will continue to evaluate.
More Assistance Available for Kentucky Medicaid Providers Affected by COVID-19
U.S Department of Health and Human Services is making $25.5 billion available to Medicaid, Children’s Health Insurance Program and/or Medicare providers. The funds are available through the American Rescue Plan and the Provider Relief Fund. Providers can apply for assistance beginning Sept. 29. For more information,
read the announcement from DMS and
review the Provider Relief Fund Future Payments website.
Report on Number of Kentucky Children Receiving Medicaid Now Available
The report lists the number of children in each county receiving either KCHIP or regular Medicaid. It is updated monthly.
2021 Behavioral Health and Substance Abuse Fee Schedule Mass Adjustment
The 2021 Behavioral Health and Substance Abuse Fee Schedule was not implemented until March 18, 2021. This requires DMS to mass adjust claims to the effective date of Jan. 1, 2021. Providers may see adjustments that could negatively or positively impact reimbursement claims with dates of services from Jan. 1, 2021 to March 18, 2021. Providers should see adjustments on the cycle dated Sept. 3, 2021.
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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