What's New
Off-Cycle Revalidations
The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), has directed Kentucky Medicaid to complete off-cycle revalidations over the next 24 months. The goal of this off-cycle revalidation is to ensure the accuracy of provider enrollment data and confirm that only legitimate, qualified providers are enrolled and participating.
During this off-cycle revalidation, Kentucky Medicaid will focus on providers that have not revalidated in the last 12 months. Kentucky Medicaid will prioritize the review of identified providers in the following order:
- High Risk
- Atypical (Providers with no NPI)
- First Moderate Risk, then Limited Risk
- Moderate Risk
- Limited Risk
Providers identified in any of these categories will be notified of their off-cycle revalidation requirement via notification from the Medicaid Partner Portal Application (MPPA) and will receive a revalidation letter outlining the action they need to take. These providers will need to submit a revalidation in MPPA, even if they revalidated in the last four years.
Due to the 24-month deadline to complete this off-cycle revalidation, providers must complete their revalidation and submit it as soon as they receive their notification/ letter. This will allow Kentucky Medicaid time to review and process these revalidations promptly, prevent provider billing issues, and meet the required deadline. Any updates that need to be made to a provider file can be included in the revalidation instead of submitting a separate maintenance. Thank you for your cooperation and assistance in this matter.
Learn to Bill Medicaid Transportation Services: Gainwell Technologies, in partnership with Kentucky Medicaid, is offering a webinar to help providers bill emergency and non-emergency transportation services. Read the transportation webinar invitation (PDF) for additional information.
Kentucky Managed Care Plans Prior Authorizations (PA): The revised Kentucky Managed Care Plans Prior Authorization by Behavioral Health Service Comparison (PDF) is now available.
Community Health Workers: Learn more about Community Health Workers (CHW) and which provider types can bill for their services.
CHW Presentation (PDF)
CHW Frequently Asked Questions (PDF)