MEDICAL ASSISTANCE (STATE MEDICAID PROGRAM)

Section 205.510 - Definitions for medical assistance law
Section 205.512 - [Repealed]
Section 205.514 - [Repealed]
Section 205.516 - [Repealed]
Section 205.518 - [Repealed]
Section 205.520 - Title and purpose of KRS 205.510 to 205.630 - Recovery from third parties for services rendered
Section 205.522 - [Effective Until 1/1/2025] Duty of Department for Medicaid Services and Medicaid managed care organizations to comply with specified sections of Subtitle 17A of KRS Chapter 304
Section 205.522 - [Effective 1/1/2025] Duty of Department for Medicaid Services and Medicaid managed care organizations to comply with specified sections of Subtitle 17A of KRS Chapter 304
Section 205.525 - Application by cabinet for waiver, waiver amendment, or request for plan amendment - Cabinet to provide updates upon request
Section 205.526 - Application for waiver to provide coverage to prerelease prisoners
Section 205.527 - Managing of IMPACT Plus program by Medicaid managed care organization - Continuation of services for eligible children - Billing - Gaps in service and lack of access
Section 205.528 - Hospital-to-Home Transition Program
Section 205.529 - Synchronization of multiple prescriptions for treatment of a chronic illness
Section 205.530 - [Repealed]
Section 205.531 - Administrative hearings
Section 205.532 - Definitions for KRS 205.532 to 205.536 - Contracts for Medicaid services by managed care organizations - Credentialing alliance - Procedures - Enrollment of and contracts with providers - Failure to agree on terms and conditions - Application date - Credentialing verification by university hospitals - Electronic verification of licensure information
Section 205.533 - Web site of managed care organization
Section 205.534 - Toll-free telephone line - Duties relating to adverse determinations - In-person meeting - Reprocessing claims - Internal appeals - Timely decisions on authorization and preauthorization requests - Monthly reports - Penalties
Section 205.535 - Medicaid enrollee not automatically assigned to managed care organization
Section 205.536 - Utilization review - Prohibition against prospective or concurrent review of prescription drug for alcohol or opioid use disorder
Section 205.5371 - Community engagement program
Section 205.5372 - Specific authorization from General Assembly required to exercise state's option to develop basic health program under federal law
Section 205.5373 - Department's duties when limited in ability to disenroll individuals from state medical assistance program
Section 205.5374 - Limitation on designation of cabinet or Department for Medicaid Services as qualified health entity
Section 205.5375 - Definitions for section - Presumptive eligibility - Determination - Requirements - Administrative regulations
Section 205.5376 - Substance use disorder treatment for incarcerated individuals - Requirements
Section 205.538 - Statistics report on cancer services for colorectal cancer among Medicaid recipients
Section 205.539 - Coverage and reimbursement for at-home anticoagulation management - Administrative regulations
Section 205.540 - Advisory Council for Medical Assistance - Membership - Expenses - Meetings - Qualifications of members
Section 205.541 - Application of clinical criteria for sepsis
Section 205.550 - Subjects on which council advises
Section 205.5510 - Definitions for KRS 205.5510 to 205.5520
Section 205.5512 - Selection of and contract with third-party administrator as pharmacy benefit manager for Medicaid managed care organizations - Requirements for department's contracts, procurement process, disclosure of information, and legislative committee review
Section 205.5514 - Department's duties regarding state pharmacy benefit management
Section 205.5516 - Compliance of payment arrangements with state and federal laws and regulations
Section 205.5518 - Required and prohibited actions by pharmacy benefit manager - Penalty for violation
Section 205.5520 - Annual recommendations regarding pharmacy benefit reimbursement methodologies and dispensing fees
Section 205.556 - Coverage for lactation consultation, breastfeeding equipment, in-home programs for pregnant and postpartum women, and telehealth or digital health services related to maternity care
Section 205.557 - [Newly enacted section not yet numbered] Medicaid reimbursement for advocacy center's child medical evaluation - Waivers - Administrative regulations
Section 205.558 - Prescreening and admissions review system
Section 205.559 - Requirements for Medicaid reimbursement to participating providers for telehealth consultations - Reimbursement for rural health clinics, federally qualified health centers, and federally qualified health center look-alikes - Location in state not required if provider offers services exclusively by telehealth - Audio-only encounters
Section 205.5591 - Medicaid providers using telehealth - Duties of cabinet, Department for Medicaid Services, and managed care organizations - Administrative regulations - Policies and guidelines
Section 205.560 - Scope of care to be designated by administrative regulations - Reimbursements mandated or prohibited - Payments to community mental health centers - Participation of providers in Medical Assistance Program
Section 205.5601 - Cabinet's reimbursement for qualifying ground ambulance service transports
Section 205.5602 - Definitions for this section and KRS 205.5601 and 205.5603 - Duties of Department for Medicaid Services regarding ground ambulance service transports - Assessment amount and administration - Need for state plan or waiver amendment - Reports
Section 205.5603 - Ambulance service assessment fund - Appropriation and transfer of fund moneys - Sole purposes of fund - Effect of invalidity of KRS 205.5602