Kentucky Revised Statutes
Chapter 205 - Public assistance and medical assistance
205.621 Increased reimbursement for Medicaid.

Kentucky Revised Statutes

Chapter 205 - Public assistance and medical assistance

205.010 Definitions for chapter.

205.020 Repealed, 1950.

205.030 Repealed, 1950.

205.040 Repealed, 1950.

205.045 Renumbered as KRS 45.235.

205.050 Repealed, 1950.

205.060 Repealed, 1942.

205.065 Repealed, 1950.

205.070 Repealed, 1950.

205.080 Repealed, 1950.

205.090 Repealed, 1966.

205.100 Repealed, 1966.

205.110 Repealed, 1966.

205.120 Repealed, 1966.

205.130 Repealed, 1966.

205.140 Repealed, 1966.

205.150 Repealed, 1966.

205.160 Repealed, 1974.

205.170 Powers of secretary.

205.172 Required reports to Legislative Research Commission.

205.173 Attorney General jurisdiction to enforce chapter and bring action -- Conditions.

205.175 Confidential treatment of information and records -- Persons to whom furnished.

205.177 Information may be shared by state and local governmental agencies -- Conditions.

205.178 Enrollment or benefit tracking agency to receive information on recipients of Medicaid and Supplemental Nutrition Assistance Program benefits -- Memorandum of understanding with departments providing information -- Independent vendors -- Mult...

205.1781 Legislative findings.

205.1783 Transitional benefit alternative -- Elderly Simplified Application Project -- Online employment and training program -- Administrative regulations.

205.179 Annual review of sites where residents receive state supplemental benefits to determine registration status of boarding home.

205.180 Destruction of records.

205.190 Repealed, 1974.

205.191 Definitions for KRS 205.178, 205.193, 205.200, 205.231, 205.232, 205.525, and 205.725.

205.193 Cabinet to establish and maintain policies and practices -- Restrictions on recipient's use of cash assistance benefits -- Penalties -- Duties of cabinet.

205.200 Eligibility for public assistance.

205.2001 "Public assistance under Title IV-A of the Federal Social Security Act standard of need" defined.

205.2002 Repealed, 1998.

205.2003 Administrative regulations for work program for public assistance recipients.

205.2005 Opt-out of 21 U.S.C. sec. 862a(a).

205.201 Duties of cabinet as to the aging and the minority elderly.

205.202 Acceptance and disposition of gifts and grants.

205.203 Authorization to provide in-home services to the aging -- Collection of fees.

205.204 Cabinet to administer Older Americans Act -- Regulatory authority.

205.210 Amount of assistance -- Proration in case of deficiency -- Resources defined.

205.211 Secretary to correct any underpayment or overpayment of public assistance benefits.

205.213 Technical amendment to material that has been incorporated by reference in administrative regulation governing Supplemental Nutrition Assistance Program.

205.215 Repealed, 1998.

205.217 Repealed, 2020.

205.220 Payments, to whom made -- Accounting -- Exemption from assignment, levy or execution.

205.222 Repealed, 1978.

205.223 Repealed, 1978.

205.225 Repealed, 1979.

205.227 Action by secretary against persons legally liable for support.

205.230 Repealed, 1964.

205.231 Appeals -- Hearing officers -- Appeal board -- Procedure.

205.232 Cash assistance benefits disqualification -- Protective payee -- Administrative regulations.

205.234 Repealed, 1996.

205.237 Public assistance claimant may have counsel -- Fees.

205.240 Public assistance funds -- Availability to secretary.

205.245 Supplementary payments.

205.250 Repealed, 1972.

205.260 Repealed, 1956.

205.270 Repealed, 1956.

205.280 Repealed, 1956.

205.290 Revolving fund -- Disbursement -- Balance not to lapse.

205.300 Repealed, 1960.

205.310 Liability of stepparent for support furnished child.

205.320 Repealed, 1956.

205.325 Repealed, 1966.

205.330 Repealed, 1972.

205.335 Repealed, 1972.

205.340 Repealed, 1972.

205.350 Repealed, 1972.

205.400 Energy Cost Assistance Program established -- Eligibility requirements -- Allocation of funds -- Payments.

205.410 Repealed, 1976.

205.420 Repealed, 1976.

205.430 Repealed, 1976.

205.440 Repealed, 1976.

205.450 Repealed, 1976.

205.455 Definitions for KRS 205.460.

205.460 Essential services -- Funding -- Collection of fees and contributions.

205.465 Repealed, 2017.

205.470 Centralized resource and referral center for aging caregivers of individuals with an intellectual disability or other developmental disability.

205.510 Definitions for medical assistance law.

205.512 Repealed, 1972.

205.514 Repealed, 1972.

205.516 Repealed, 1972.

205.518 Repealed, 1972.

205.520 Title and purpose of KRS 205.510 to 205.630 -- Recovery from third parties for services rendered.

205.522 Duty of Department for Medicaid Services and Medicaid managed care organizations to comply with specified sections of Subtitle 17A of KRS Chapter 304. (Effective until January 1, 2023).

205.522 Duty of Department for Medicaid Services and Medicaid managed care organizations to comply with specified sections of Subtitle 17A of KRS Chapter 304. (Effective January 1, 2023).

205.525 Application by cabinet for waiver, waiver amendment, or request for plan amendment -- Cabinet to provide updates upon request.

205.526 Application for waiver to provide coverage to prerelease prisoners.

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.

205.528 Hospital-to-Home Transition Program.

205.529 Synchronization of multiple prescriptions for treatment of a chronic illness.

205.530 Repealed, 1974.

205.531 Administrative hearings.

205.532 Definitions for KRS 205.532 to 205.536 -- Contracts for Medicaid services by managed care organizations -- Credentialing alliance -- Clean application -- Enrollment of and contracts with providers -- Failure to agree on terms and conditions -...

205.533 Web site of managed care organization.

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.

205.535 Medicaid enrollee not automatically assigned to managed care organization.

205.536 Utilization review -- Prohibition against prospective or concurrent review of prescription drug for alcohol or opioid use disorder.

205.5371 Community engagement program.

205.5372 Specific authorization from General Assembly required to exercise state's option to develop basic health program under federal law.

205.5373 Department's duties when limited in ability to disenroll individuals from state medical assistance program.

205.5374 Limitation on designation of cabinet or Department for Medicaid Services as qualified health entity.

205.5375 Definitions for section -- Presumptive eligibility -- Determination -- Requirements -- Administrative regulations.

205.5376 Substance use disorder treatment for incarcerated individuals -- Requirements.

205.538 Statistics report on cancer services for colorectal cancer among Medicaid recipients.

205.540 Advisory Council for Medical Assistance -- Membership -- Expenses -- Meetings -- Qualifications of members.

205.550 Subjects on which council advises.

205.5510 Definitions for KRS 205.5510 to 205.5520.

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 committe...

205.5514 Department’s duties regarding state pharmacy benefit management.

205.5516 Compliance of payment arrangements with state and federal laws and regulations.

205.5518 Required and prohibited actions by pharmacy benefit manager -- Penalty for violation.

205.5520 Annual recommendations regarding pharmacy benefit reimbursement methodologies and dispensing fees.

205.557 Medicaid reimbursement for advocacy center's child medical evaluation -- Waivers -- Administrative regulations.

205.558 Prescreening and admissions review system.

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 -- Audio-only enc...

205.5591 Medicaid providers using telehealth -- Duties of cabinet, Department for Medicaid Services, and managed care organizations -- Administrative regulations -- Policies and guidelines.

205.560 Scope of care to be designated by administrative regulations -- Reimbursements mandated or prohibited -- Assessment of health care provider credentials -- Participation of providers in Medical Assistance Program.

205.5601 Cabinet’s reimbursement for qualifying ground ambulance service transports.

205.5602 Duties of Department for Medicaid Services regarding ground ambulance service transports -- Assessment amount and administration -- Need for state plan or waiver amendment -- Reports.

205.5603 Ambulance service assessment fund -- Appropriation and transfer of fund moneys -- Sole purposes of fund -- Effect of invalidity of KRS 205.5602.

205.5605 Definitions for KRS 205.5605 to 205.5607.

205.5606 Kentucky Independence Plus Through Consumer-Directed Services Program -- Consumer participation -- Responsibilities of cabinet and fiscal intermediary -- Background screening -- Regulations.

205.5607 Applicability of KRS Chapter 342.

205.561 Report on the dispensing of prescription medications.

205.5621 Definitions for KRS 205.5621 to 205.5625.

205.5622 Kentucky Pharmaceutical Assistance Program -- Contingency for establishment -- Purpose -- Eligibility -- Enrollment priority.

205.5623 Department's powers in providing program benefits.

205.5624 Payment of benefits -- Limitations -- Qualification for coverage.

205.5625 Residency standards.

205.5631 Definitions for KRS 205.5631 to 205.5639.

205.5632 Prior authorization requirements -- Administrative regulations.

205.5634 Coordination of use of utilization data -- Identification of appropriate use of pharmaceuticals -- Determination of need for educational intervention.

205.5636 Drug Management Review Advisory Board -- Membership -- Officers -- Meetings.

205.5638 Duties and responsibilities of board.

205.5639 Effect of board recommendations -- Written exceptions -- Final decision -- Appeal.

205.564 Pharmacy and Therapeutics Advisory Committee -- Membership -- Duties -- Information posted on Web site -- Recommendations -- Presentations by interested parties -- Appeals -- Administrative regulations.

205.5641 Prior authorization not required for medication-assisted therapies in pilot project -- No restrictions on participating pharmacies and pharmacists.

205.565 Cabinet to recognize unique costs of pediatric teaching hospital.

205.566 Electronic medical record database.

205.570 Repealed, 1974.

205.575 Repealed, 1993.

205.576 Repealed, 1993.

205.577 Repealed, 1993.

205.578 Repealed, 1993.

205.580 Repealed, 1974.

205.585 Review of services and treatment for sickle cell disease -- Annual report -- Short title.

205.590 Technical advisory committees.

205.591 "Fair market value" of applicant's property if used to determine eligibility.

205.592 Eligibility of pregnant women, new mothers, and children up to age 1 to participate in Kentucky Medical Assistance Program.

205.593 Prohibition against health insurer's considering individual's eligibility for or receipt of medical assistance in enrollment or payment of benefits -- Application of claims payment requirements to Medicaid services.

205.594 Health coverage for child under medical child support order -- Duties of health insurers.

205.595 Health coverage for child under medical child support order -- Duties of employers.

205.596 Prohibition against health insurer's imposing requirements on state agency assigned rights of individual eligible for medical assistance that are different from those applicable to agent or assignee of other covered individual.

205.597 Health coverage through insurer of noncustodial parent of child under medical child support order.

205.598 Withholding of income and state tax refund of person required by court to provide cost of child's health service -- Priority of claims for child support over costs of reimbursement of child medical support.

205.600 Repealed, 1982.

205.604 Repealed, 1972.

205.610 Repealed, 1972.

205.615 Use of allowable Medicaid funding for trauma care costs.

205.617 Expansion of Medicaid coverage for screening and treatment of breast or cervical cancer or precancerous conditions -- Short title.

205.618 Coverage for tobacco cessation medications and services.

205.619 Medicaid plan amendment to permit establishing of Kentucky Long-Term Care Partnership Insurance Program.

205.620 Repealed, 1966.

205.621 Increased reimbursement for Medicaid.

205.622 Billing of third party by vendor for medical services.

205.623 Information on claims paid for insurance policyholders and dependents -- Use of data -- Confidentiality of information -- Prohibited fees.

205.624 Assignment to cabinet by recipient of rights to third-party payments -- Right of recovery by cabinet.

205.626 Time assignment becomes enforceable -- Payment to cabinet -- Attorney's fees.

205.627 Repealed, 1996.

205.628 Liability of recipient.

205.629 Notification of cabinet in actions seeking recovery for recipient.

205.630 Prohibited activity by cabinet -- Injunctive relief.

205.631 Life settlement proceeds for long-term care services not considered as resource or asset for Medicaid eligibility -- Notice of exhaustion of proceeds -- Medicaid and applied income payments to begin immediately upon exhaustion of life settlem...

205.6310 Cabinet to establish system to reduce unnecessary hospital emergency room utilization and costs.

205.6311 Substance use disorder treatment benefit -- Administrative regulations -- Contracts with Medicaid managed care organizations -- Annual report.

205.6312 Prohibit charging medical recipients copayments or cost sharing.

205.6313 Medicaid reimbursement for primary care practitioners at community mental health centers.

205.6314 Review of reimbursement rates for emergency transportation providers -- Promulgation of administrative regulations relating to emergency transportation providers.

205.6315 Requirements when private peer review organization is contracted with to conduct reviews of levels of care.

205.6316 Review of procedures for medical assistance reimbursement of pharmacists to reduce fraud and abuse -- Dispensing fee.

205.6317 Department for Medicaid Services to develop strategies for reimbursing and paying persons participating in the Supports for Community Living Waiver Program -- Allocation of slots -- Administrative regulations -- Funding.

205.63171 Short title for KRS 205.6317.

205.6318 Cabinet to establish integrated system to enhance program integrity of Medical Assistance Program.

205.632 Pilot project to create coverage provisions and reimbursement criteria for telemonitoring services based on evidence-based best practices provided by a qualified medical provider or community action agency.

205.6320 Cabinet to strengthen managed care component of KenPAC Program and to establish standards for access and quality for organizations serving Medicaid recipients.

205.6322 Cabinet to seek to prohibit sheltering of assets in long-term-care cases.

205.6324 Cabinet to enhance third-party resource collection capacity.

205.6326 Review of Medicaid reimbursement systems -- Implementation of a standardized patient assessment tool and consistent quality-of-care mandates.

205.6328 Quarterly reports to General Assembly regarding Medicaid program changes -- Expiration provision.

205.6330 Repealed, 1996.

205.6332 System for monitoring use of covered services using appropriate technology and identification card.

205.6333 Reimbursement for in-network suppliers of durable medical equipment, prosthetics, orthotics, and supplies -- Reimbursement rate -- Timeframe for claim submissions.

205.6334 Request for necessary waivers of federal law.

205.6336 Repealed, 2017.

205.6338 Implementation of pilot projects to provide health care to frail elderly Medicaid-eligible individuals.

205.634 Payments prohibited to out-of-state health facility providing services without required certificate of need -- Nonreimbursement of out-of-state providers of residential care for children -- Exception -- Administrative regulations.

205.635 Skilled nursing services provided to Medicaid recipients by adult day health care programs.

205.636 Temporary COVID-19 personal care attendant -- Training and competency requirements -- Application for waiver or plan amendment.

205.637 Enhanced Medicaid payments to county-owned or operated hospitals -- Payments to other hospitals.

205.638 Portion of hospital provider tax collections to fund enhancements to inpatient payments to hospitals.

205.639 Definitions for KRS 205.639 to 205.640.

205.640 Medical Assistance Revolving Trust Fund (MART) -- Distribution of disproportionate share funds -- Authority for administrative regulations -- Duties of hospitals receiving funds from MART.

205.6401 Penalty for failure of Medicaid managed care organization to provide accurate paid claims listing.

205.6403 Administrative regulations to comply with change in federal law -- Payments contingent on federal participation.

205.6405 Definitions for KRS 205.6405 to 205.6408.

205.6406 Hospital rate improvement programs -- Calculation and payment of assessment on hospitals to provide state matching dollars for federal Medicaid funds -- Supplemental payments to hospitals -- Federal participation and approval required for im...

205.6407 Hospital Medicaid assessment fund.

205.6408 Uses of excess disproportionate share taxes.

205.641 Repealed, 2018.

205.642 Pervasive developmental disorders -- Definition for KRS 200.654, 200.660, 347.020, and 387.510 -- Waiver application -- Report.

205.643 IMPACT Plus Program -- Provider to receive copy of criteria used in audit, evaluation, or review.

205.645 Recognition of varying overhead costs.

205.646 External independent third-party review of Medicaid managed care organization's final decision denying a health care service or a claim for reimbursement -- Submission of multiple claims in a single review -- Appeal -- Administrative regulati...

205.647 State pharmacy benefit manager's report to Department for Medicaid Services -- Requirements for Medicaid services contracts entered into or renewed on or after March 27, 2020 -- Administrative regulations -- Reimbursement rates between pharma...

205.648 Plan amendment, waiver, or alternative payment model for services of certified community health workers -- Reimbursement -- Services provided -- Not be considered duplicative -- Administrative regulations and approvals.

205.6481 Legislative findings.

205.6483 Kentucky Children's Health Insurance Program -- Purposes.

205.6485 State child health plan -- Eligibility criteria -- Schedule of benefits -- Premium contributions -- Access. (Effective until January 1, 2023).

205.6485 State child health plan -- Eligibility criteria -- Schedule of benefits -- Premium contributions -- Access. (Effective January 1, 2023).

205.6487 Establishment of trust fund -- Maintenance.

205.6489 Administration -- Outreach -- Data collection.

205.6491 Repealed, 2017.

205.6495 Short title for KRS 205.6481 to 205.6495 and KRS 304.17A-340.

205.6497 Required provisions in plans.

205.650 Repealed, 1998.

205.660 Repealed, 1998.

205.670 Repealed, 1998.

205.680 Repealed, 1998.

205.690 Reports to General Assembly.

205.700 Repealed, 1998.

205.702 Educational and vocational programs for parents receiving public assistance -- Reports by cabinet.

205.703 Educational and vocational programs eligible for supportive services -- Prohibition against discontinuance of service to low income parents except under certain circumstances.

205.704 Preparation and submission of strategic plan to further education of low income parents -- Parties included in planning process.

205.705 Legislative intent regarding child support statutes.

205.710 Definitions for KRS 205.712 to 205.800.

205.712 Department for Income Support -- Duties -- Cabinet to process child support payments -- State disbursement unit -- Cabinet's cooperation with courts and officials -- Reporting of obligors -- Denial, suspension, and revocation of licenses -- D...

205.713 Standardized forms for entry of state case registry information.

205.715 Debt due and owing to state by parents.

205.720 Assignment -- Subrogation -- Distribution of child support payments -- Effect of termination of Title IV-D services.

205.721 Title IV-A services available to individuals not receiving public assistance benefits -- Continuation of IV-D services -- Fee for services -- Exemption -- Annual fee.

205.725 Action when application received by cabinet -- Exceptions -- Definition.

205.730 Cabinet's duty to locate custodial and noncustodial parents -- Enforcement of child support obligations -- Registry of information relating to parents -- Assistance from governmental agencies -- Limits on availability of information.

205.732 Employment assistance program for low-income noncustodial parents.

205.735 Information to be supplied by employer.

205.740 Repealed, 1988.

205.741 Repealed, 1990.

205.743 Repealed, 1990.

205.744 Repealed, 1990.

205.745 Child support lien or levy in favor of cabinet -- Filing of notice -- Foreclosure actions -- Immobilization of vehicles of child support obligors.

205.750 Payments to be made through the state agency or the agency's designee.

205.752 Penalty imposed upon payor for tender of dishonored check.

205.755 Manner for receipt and distribution of payments.

205.760 Repealed, 1988.

205.765 Judicial proceeding to secure support.

205.766 Concurrent jurisdiction of Circuit and District Courts in certain child support cases.

205.767 Surety to guarantee payment of overdue support.

205.768 Release of information to consumer reporting agencies -- Notice -- Charge for information.

205.7685 Credit report from consumer reporting agency requested for purpose of child support recovery.

205.769 Federal and state income tax refund offsets.

205.7695 Sharing of state tax information for child support collection.

205.770 Child custody and visitation rights.

205.772 Data match agreements between cabinet and financial institutions -- Surrender of assets when parent is subject to lien -- Fee -- Financial institutions not liable.

205.774 Wage reporting and financial institution match systems -- Agreements.

205.775 Repealed, 1988.

205.776 Disclosure of information about data match system to depositors -- Penalty -- Liability of financial institution -- Fee.

205.778 Lien against account of parent owing child support -- Notice -- Account activity fees -- Priority of lien.

205.7785 Interstate lien to enforce Kentucky child support obligation -- Lien to enforce obligation credited in another state -- Priority of out-of-state lien -- Certification of authority.

205.780 Legal action for reimbursement.

205.782 Service of process by constable in county containing city of the first class.

205.785 Identity of parent -- Information concealment.

205.790 Procedures -- Actions -- Remedies.

205.792 Use of administrative process to determine and enforce support obligations.

205.793 Administrative subpoena for information relating to child support -- Financial institution may deduct funds from account -- Action to enforce subpoena.

205.795 Regulations.

205.796 Divulging of information by employees or agents of the Commonwealth -- Penalties for unauthorized disclosure.

205.7965 Release of data to government agencies.

205.798 Cabinet may coordinate with other agencies.

205.800 Referral to local officials -- Cooperative arrangements for administering.

205.802 Standardized forms for entry into state case registry.

205.810 Repealed, 1998.

205.830 Legislative intent.

205.835 Disclosure of financial data pertinent to applicants for or recipients of benefits -- Fee -- Written consent.

205.845 Repealed, 1994.

205.8451 Definitions for KRS 205.8451 to 205.8483.

205.8453 Responsibility for control of fraud and abuse.

205.8455 Recipient Utilization Review Committee -- Authority.

205.8457 Responsibility of managed care primary physician.

205.8459 Emergency service.

205.8461 Unlawful referral practices of provider -- Penalties.

205.8463 Fraudulent acts -- Penalties.

205.8465 Mandatory reporting of violations -- Confidentiality -- Prohibition against employer discrimination or retaliation.

205.8467 Liability of violators -- Payment of penalties to Medicaid trust fund.

205.8469 Enforcement proceedings by Attorney General.

205.8471 Lien on property of provider or recipient defrauding Medicaid program.

205.8473 Reliance on written governmental advice as defense.

205.8475 Forfeiture of provider's license.

205.8477 Disclosure requirements for Medicaid providers, fiscal agents, and managed care entities -- Disclosure requirements for owners and investors of health facilities and health services -- When disclosure must be provided.

205.8479 Report of license or certificate suspension, revocation, or limitation.

205.8481 Prohibition against representation of provider by staff of Attorney General in private practice.

205.8483 Toll-free hotline for receiving reports of fraud and abuse -- Report.

205.850 Repealed, 1994.

205.855 Repealed, 1994.

205.900 Definitions for KRS 205.905 to 205.920.

205.905 Subsidy for personal care assistance.

205.910 Eligibility standard -- Subsidy not income for federal law purposes -- Supplements other programs.

205.915 Appeal of decision by aggrieved party.

205.920 Regulations.

205.925 Implementation of KRS 205.900 to 205.920 by cabinet.

205.935 Definitions for KRS 205.940.

205.940 Representative payee fund.

205.950 Repealed, 2020.

205.955 Repealed, 2020.

205.990 Penalties.

205.991 Repealed, 1979.

205.992 Penalties for child support recovery offenses.