Authorized delegate form changes
Effective Dec. 1, 2019, DMS will accept only the new authorized delegate form. See Additional Information on this page to download the form. Previously submitted or approved authorized delegate forms are valid until their expiration date
as long as all information is current and correct.
Updating a State License
When Kentucky Medicaid providers update their licenses, they must submit a copy of the license to Kentucky Medicaid through KY MPPA to keep their provider information updated.
Provider types listed below who update their licenses with their respective boards at least 15 working days prior to the expiration date, and no later than the last day to renew, will not be required to submit licensure verification to DMS until revalidation or maintenance is necessary. Otherwise, the license verification must be submitted to DMS through KY MPPA .
Note: Providers with out-of-state licenses must submit updated license information through the KY MPPA.
From DMS: Physicians enrolled as Kentucky Medicaid providers with active licenses due for renewal with the Kentucky Board of Medical Licensure and the license is set to expire Feb. 29. 2020 are advised to update their KBML licenses at least 15 days prior to the expiration date and no later than Feb. 14, 2020.
KBML is working with DMS to transmit updated license information electronically. With this new process, a copy of your KBML license no longer needs to be submitted to DMS until revalidation or maintenance is necessary.
Providers who don't update their license with the KBML 15 working days prior to the expiration date or by Feb. 14, 2020 must submit their updated licenses through KY MPPA to update their provider files. Submission of paper licenses no longer is accepted.
Note: Providers who have out-of-state license are required to submit updated license information through the KY MPPA.
MPPA Enrollment, Revalidation, and Maintenance
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