Public Comment period for updates to the 1915(c) Home- and Community-Based and Model II waiver applications
(Oct 2, 2020) The Department for Medicaid Services is conducting a public comment period Monday, Oct. 5 - Friday, Nov. 6, 2020 for updates to the Home- and Community-Based and Model II (MIIW) waiver applications. 1915(c) Home- and Community- Based Services (HCBS) waivers expire every five years and must be renewed with the Centers for Medicare and Medicaid Services. The HCBS and MIIW waivers are due for renewal this year.
summary of HCBS and MIIW application updates
recording of the HCBS and MIIW Public Comment Webinar presentation
View the HCBS and MIIW Public Comment Webinar
a recording of the HCBS and MIIW Public Comment Webinar question-and-answer session
Public Notice: 1115 Waiver Substance Use Disorder Demonstration Proposed Amendment
(Sept. 20, 2020) In accordance with 42 CFR 431.408, the Cabinet for Health and Family Services Department for Medicaid Services announces its intention to file an 1115 Amendment Application with the Centers for Medicare and Medicaid Services (CMS) no later than Nov. 16, 2020, requesting Medicaid coverage for SUD services to incarcerated individuals. The changes outlined below will become effective upon CMS approval. Please note the public comment period for the SUD 1115 waiver amendment has been extended from Oct. 30 to Nov. 6, 2020.
1115 Waiver Amendment
SUD 1115 Incarceration Amendment Town Hall
1115 Waiver Town Hall #1 recording
View the 1115 Waiver Town Hall #2 presentation
Public Notice: Beneficiary Cost Sharing
In accordance with 42 CFR 447.57, the Cabinet for Health and Family Services Department for Medicaid Services provides public notice of its intent to file a state plan amendment with the Centers for Medicare and Medicaid Services no later than Sept. 1, 2020, amending the cost-sharing obligations of Kentucky Medicaid beneficiaries. The cost-sharing obligations become effective Dec. 1, 2020 and will be the same for all Medicaid beneficiaries; therefore, cost-sharing applies to the new eligibility groups authorized by the Affordable Care Act and the old or existing Medicaid eligibility groups.
Public Notice: CHIP Support
The Cabinet for Health and Family Services Department for Medicaid Services, in accordance with 42 CFR 447.205, provides public notice of its intent to file a state plan amendment, effective Oct. 24, 2019, to strengthen behavioral health coverage for children and pregnant women eligible through the Children’s Health Insurance Program (CHIP). Section 5022 of the SUPPORT Act amends section 2103(c)(5) of the Social Security Act (the Act) to make behavioral health coverage a required benefit for CHIP effective Oct. 24, 2019.
Read the Public Notice.
Public Notice: School-Based Reimbursement
In accordance with 42 CFR 447.205, CHFS provides public notice of its intent to file a state plan amendment (SPA), effective July 1, 2020. The purpose of the SPA is to modify reimbursement for school-based services related to individualized service plan, section 504 accommodation plan pursuant to 34 C.F.R. § 104.36, individualized healthcare plan, individualized family service plan or otherwise medically necessary service including those described under Item 4.b. EPSDT in Supplement to Attachment 3.1-A/B, by a cost-reimbursement methodology. Final reimbursement is based on certified reports submitted using the methodology allowed under the Kentucky School-Based Cost Report approved by the Centers for Medicare and Medicaid Services.
Read the public notice.
Public Notice page
New Kentucky Level of Care System (KLOCS)
(July 17, 2020) - Aug. 3, 2020, all nursing facility providers, institutionalized hospice service providers and ICF/IID providers are required to use the Kentucky Level of Care System (KLOCS). Training materials will be available the week of July 27. Please refer to the
KLOCS page for more information.
(July 17, 2020)
907 KAR 1:604 (AAC) - Recipient cost-cost sharing eliminates co-pays for Medicaid Members.
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.
Fee for Service/Managed Care Organization Prior Authorization Announcement
(Jun. 30, 2020) - Effective with dates of service beginning Aug. 1, 2020 MCOs may resume their respective prior authorization policies with the exception of behavioral health and substance use disorder (SUD) services. Behavioral health and SUD services are defined as services provided by any behavioral health provider type (02, 03, 04, 05, 06, 23, 26, 30, 62, 63, 66, 67, 81, 82, 83, 84, 89, 92), services listed on the Behavioral Health and Substance Abuse Services Inpatient and Outpatient Fee Schedules and services listed on the Community Mental Health Center Mental Health Substance Abuse Codes and Units of Service Fee Schedule. For services scheduled in early Aug. 2020, it is recommended that providers be allowed the ability to obtain prior authorization in July 2020.
KY HEALTH Section 1115 Reissuance
KY Evaluation Design Approval Letter
KY HEALTH Section 1115 Demonstration
Medicaid Contract Information
Important Information for 2021
Public Charge Rule
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